EP1670362A1 - Implantable device fastening system and methods of use - Google Patents

Implantable device fastening system and methods of use

Info

Publication number
EP1670362A1
EP1670362A1 EP05705996A EP05705996A EP1670362A1 EP 1670362 A1 EP1670362 A1 EP 1670362A1 EP 05705996 A EP05705996 A EP 05705996A EP 05705996 A EP05705996 A EP 05705996A EP 1670362 A1 EP1670362 A1 EP 1670362A1
Authority
EP
European Patent Office
Prior art keywords
attaching means
housing
ofthe
delivery system
staple
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
EP05705996A
Other languages
German (de)
French (fr)
Other versions
EP1670362B1 (en
EP1670362B2 (en
EP1670362A4 (en
Inventor
Janel Birk
Frederick L. Coe
Robert E. Hoyt, Jr.
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Apollo Endosurgery Inc
Original Assignee
Inamed Medical Products Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Family has litigation
First worldwide family litigation filed litigation Critical https://patents.darts-ip.com/?family=34826003&utm_source=google_patent&utm_medium=platform_link&utm_campaign=public_patent_search&patent=EP1670362(A1) "Global patent litigation dataset” by Darts-ip is licensed under a Creative Commons Attribution 4.0 International License.
Application filed by Inamed Medical Products Corp filed Critical Inamed Medical Products Corp
Priority to EP11194523.4A priority Critical patent/EP2433672B1/en
Priority to PL05705996T priority patent/PL1670362T3/en
Priority to EP10181580.1A priority patent/EP2260773B2/en
Publication of EP1670362A1 publication Critical patent/EP1670362A1/en
Publication of EP1670362A4 publication Critical patent/EP1670362A4/en
Publication of EP1670362B1 publication Critical patent/EP1670362B1/en
Application granted granted Critical
Publication of EP1670362B2 publication Critical patent/EP1670362B2/en
Active legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064Surgical staples, i.e. penetrating the tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/0682Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
    • A61B17/0684Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil having a forming anvil staying above the tissue during stapling
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02Access sites
    • A61M39/0208Subcutaneous access sites for injecting or removing fluids
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831Material properties
    • A61B2017/00867Material properties shape memory effect
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064Surgical staples, i.e. penetrating the tissue
    • A61B2017/0647Surgical staples, i.e. penetrating the tissue having one single leg, e.g. tacks
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064Surgical staples, i.e. penetrating the tissue
    • A61B2017/0649Coils or spirals
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02Access sites
    • A61M39/0208Subcutaneous access sites for injecting or removing fluids
    • A61M2039/0223Subcutaneous access sites for injecting or removing fluids having means for anchoring the subcutaneous access site
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02Access sites
    • A61M39/0208Subcutaneous access sites for injecting or removing fluids
    • A61M2039/0229Subcutaneous access sites for injecting or removing fluids having means for facilitating assembling, e.g. snap-fit housing or modular design
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02Access sites
    • A61M39/04Access sites having pierceable self-sealing members
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/1414Hanging-up devices
    • A61M5/1415Stands, brackets or the like for supporting infusion accessories

Definitions

  • the present invention relates to the fields of implantable medical devices and surgical instruments and fasteners.
  • the present invention encompasses methods of fastening devices or implants in surgical procedures and the surgical fasteners and instruments used in the process.
  • DESCRIPTION OF THE RELATED ART Surgical fasteners such as staples, clips, clamps, bands, tacks, or other wound or incision closure devices are commonly used in surgical procedures to allow a surgeon to fasten, secure and/or repair body tissue. Examples of surgical fasteners are given in U.S. Pat. Nos. 4,994,073 or 4,950,284 or 4,934,364 and 4,932,960.
  • Surgical fasteners have been used in surgical procedures to eliminate the need for suturing, which is both time consuming and inconvenient. In these applications the surgeon often uses a fastener implanting device loaded with one or more surgical fasteners to accomplish in a few seconds what would have taken many minutes to perform by suturing. This reduction in operating time reduces blood loss and trauma to the patient. Typically, such fastening systems have been used mainly for the closure of incisions or wounds, or to fasten tissues together. A surgical fastening system that could be used with a number of types of implantable devices would be beneficial for surgeons. Currently, surgical devices that incorporate fastening systems often use extremely specialized systems that may be unnecessarily complicated and are unsuitable for adaptation to other applications.
  • the majority of implantable devices are secured with sutures.
  • the port is sutured into place with 4 to 5 sutures against the rectus muscle sheath.
  • Such placement of the sutures is often challenging because the ports are placed below several inches of fat, and suturing the port often takes as long as placing the band itself.
  • An improved fastening system would allow easy, one-step attachment with security equivalent to the sutured device.
  • the present invention overcomes such problems in the art.
  • the present invention encompasses surgical fastening systems wherein an implantable device either contains a plurality of fasteners in pre-deployment position, or wherein an implantable device may have a housing fitted over the device, wherein the housing contains a plurality of fasteners in pre-deployment position. Accordingly, the present invention also encompasses a deployment system that optionally positions the implantable device, and which causes the fasteners to move into post-deployment position.
  • Figure 1 is an elevation view of a radial pivot fastener with staples in pre- deployment position
  • Figure 2 is an elevation view of the radial pivot fastener of Figure 1 with staples in deployed position
  • Figure 3 is a detail elevation view of the radial pivot fastener of Figure 1 with staples in pre-deployment position
  • Figure 4 is a detail elevation view of the radial pivot fastener of Figure 2 with staples in deployment position
  • Figure 5 is an elevation view of a delivery system
  • Figure 6 is a cutaway view of the delivery system shown in Figure 5 and a port fastener
  • Figure 7 is a detail cutaway elevation view ofthe distal end ofthe delivery system of Figure 6 and a port fastener in pre-deployment position
  • Figure 8 is a detail cutaway elevation view ofthe distal end ofthe delivery system of Figure 6 and a port fasten
  • Figure 48 is a side view of a closed metal loop fastening system incorporated into a device;
  • Figure 49 is a top view of device incorporating the closed metal loop fastening system of Figure 48;
  • Figure 50 is a side view of a two-part snap fit fastening system.
  • Figure 51 is an elevation view of a another closed metal loop system using curved pins or hooks
  • Figure 52 is a side view of the closed metal loop system using the curved pins or hooks of Figure 51 incorporated into a device
  • Figure 53 shows top and side views of a curved pin fastening system incorporated into a device
  • Figure 54 shows top and side views of another curved pin fastening system incorporated into a device
  • Figure 55 shows bottom and side view of a spring screw fastening system
  • Figure 56 shows side view of a folding baseplate with curved fasteners in its open and closed positions
  • Figure 57 shows top and side views of rotating hook fasteners incorporated into a device
  • Figure 58 is a top elevation view of a rotating disc fastening system with fasteners in pre-deployment position
  • Figure 59 is a bottom elevation view of the rotating disc fastening system of Figure 58 with fastener in post-deployment position
  • Figure 60 is a bottom view of the rotating disc fastening system of
  • Figure 63 is cutaway side view of a delivery system.
  • Figure 64 is a side elevation view of a delivery system.
  • Figure 65 is a top view ofthe actuator lever ofthe delivery system of Figures 63 and 64.
  • Figure 66 is a side view of the actuator lever of the delivery system of Figures 63 and 64.
  • Figure 67 is a bottom view ofthe actuator lever ofthe delivery system of Figures 63 and 64.
  • Figure 68 is a side elevation view of the actuator lever of the delivery system of Figures 63 and 64.
  • Figure 69 is a partially exploded and cutaway view ofthe port cover ofthe delivery system of Figures 63 and 64.
  • Figure 70 is a partial cutaway view of the port cover of the delivery system of Figures 63 and 64.
  • Figure 71 is a back view ofthe port cover ofthe delivery system of Figures 63 and 64.
  • Figure 72 is an elevated side view ofthe port cover ofthe delivery system of Figures 63 and 64.
  • Figure 73 is an elevated bottom view of a loading fixture.
  • Figure 74 is a bottom view of a loading fixture.
  • Figure 75 is an elevated view of a loading fixture.
  • Figure 76 is an elevated view of a disc fastener/port/loading fixture assembly.
  • Figure 77 is an exploded view of a disc fastener/loading fixture assembly.
  • DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention encompasses surgical fastening systems wherein an implantable device either contains a plurality of fasteners (e.g.
  • an implantable device may have a detachable housing fitted over the device, wherein the housing contains a plurality of fasteners in pre-deployment position.
  • the detachable housing and fasteners may be made of various materials known in the art for the manufacture of surgical fasteners and implants.
  • the fasteners may be made of metal, polymer, or other suitable materials.
  • the detachable housing may be made of metal, polymer, ceramic, or composites; for instance polysulfone, acetyl copolymers, titanium, elastomers and stainless steel are commonly used.
  • the materials must be biocompatible, i.e., they do not adversely affect the surrounding living environment, and conversely, their performance is not adversely affected by the surrounding living environment.
  • the materials may be inert non-absorbable or biodegradable. Inert materials may be fairly indestructible and maintain their form and function for extended periods of time.
  • Metals and metal alloys, and particularly titanium and titanium alloys, are used for a great variety of implantable articles for medical applications. All implantable articles suffer from some degree of bio-incompatibility, which may be manifested as tissue inflammation, necrosis, hyperplasia, mutagenicity, toxicity, and other reactions, such as attack by giant cells, leukocytes and macrophages.
  • the present invention encompasses the use of such coatings on the surface ofthe fasteners, the removable housing, or the device.
  • Some of the coatings that may be used in materials to be implanted include biological agents (such as genetic material or cellular material) or chemical agents (such as anti-proliferation reagents or cell-growth factors) to reduce problems associated with hyperplasia or inflammation.
  • These agents may be mixed with binders such as elastomers or bio-resorbable polymers to the surface of a metal or polymer object.
  • binders such as elastomers or bio-resorbable polymers to the surface of a metal or polymer object.
  • the fasteners contemplated herein, including staples, are often constructed of wire and thus have a relatively large surface area for their size. Accordingly, methods that allow the addition of biological and biochemical agents to the surface of the implant may be advantageous in minimizing the adverse reactions of body tissues with the implant. These may include coatings applied to stainless steel and titanium alloys (e.g., NiTi alloys) to retard tissue reactions.
  • Such coatings have been based upon stable bio-compatible polymers (such as styrene-isobutylene-styrene (SIBS)) and bio-resorbable polymers, such as polyglycolic acid.
  • SIBS styrene-isobutylene-styrene
  • the active chemical or biological agent is mixed with the polymeric coating material, and the agent then elutes from the coating once the implant is placed in the body.
  • the fasteners may be made of shape memory alloy (SMA).
  • SMA shape memory alloy
  • the driving force for making metal medical devices from shape memory alloys lies in their great resistance to permanent deformation as compared to conventional alloys employed in this application.
  • Alloys used in various medical instruments have relied on stainless steel, high nickel alloys such as ElgiloyTM and titanium based alloys, all of which can be given quite high yield strength through work hardening. Normal metals, even with very high yield strength, cannot sustain strains much greater than 0.2% without suffering a permanent set. Once a bend or kink has been sustained in a device fabricated from one of the above conventional alloys it is virtually impossible to remove.
  • shape memory alloys such as Au ⁇ Cd, Cu ⁇ Zn ⁇ Al, Ni ⁇ Ti and many others makes possible the complete "elastic" recovery of strains as great as 10%.
  • Shape memory alloys belong to a class which exhibit thermoelastic martensite transformation.
  • martensite refers to the crystalline phase which is produced in steels when quenched from a high temperature.
  • the phase which exists at the elevated temperature is referred to as austenite; these terms have been carried over to describe the transformations which occur in shape memory alloys.
  • austenite When a steel has been quenched from the austenitic temperature to martensite, to again form austenite requires heating the structure to quite high temperatures, usually in excess of 1400° F.
  • thermoelastic shape memory alloys can change from martensite to austenite and back again on heating and cooling over a very small temperature range, typically from 18 to 55° F.
  • the transformation of a shape memory alloy is usually described by a hysteresis curve in which it is shown that on cooling from the austenitic phase, often called the parent phase, martensite starts to form at a temperature designated as Ms and upon reaching the lower temperature, M F , the alloy is completely martensitic. Upon heating from below the M F temperature, the martensite starts to revert to the austenitic structure at As, and when the temperature designated as A F is reached, the alloy is completely austenitic.
  • the Young's Modulus of austenite is ⁇ 12xl 0 6 psi, while that for martensite is ⁇ 4xl 0 6 psi; and the yield strength, which depends on the amount of cold work the alloy is given, ranges from 28 to 100 ksi for austenite and from 10 to 20 ksi for martensite.
  • the unique feature of shape memory alloys is their ability to recover deformation. When a shape memory alloy specimen, in its martensitic form is subjected to stress, the strain is accommodated by the growth and shrinkage of individual martensite variants rather than by the mechanisms which prevail in conventional alloys: slip, grain boundary sliding and dislocation motion.
  • the fasteners may be optionally made of an S?MA such as NiTi. It is within the scope ofthe present invention that such fastening systems as herein described are able to be fastened into bodily tissue in less time than would be required to suture the device into place.
  • the placement and fixation ofthe fastening system should take no more than five minutes. Additionally, the fixation system is able to be entirely unfastened and removed from the tissue in order to facilitate repositioning of the device, or to remove the implanted device entirely. Such implantation and extraction will not cause increased trauma to the patient, and the fixation system will not cause more adhesions than the traditional suturing method. The average surgeon or other health professional is reliably and consistently able to perform fixation and extraction ofthe fastening system. Additionally, during the manufacture of such fixation systems described herein, the size ofthe fasteners determines the depth into the bodily tissue into which the fasteners will deploy.
  • fixation of an access port should occur at a depth below the device not to exceed 3mm.
  • the bodily tissue into which the fasteners are deployed is the fascia.
  • the bodily tissue to which the device is attached will vary depending on the specific device. Additionally, the attachment ofthe fastening system into tissue will not cause tissue damage during placement or during body motion; for example, an access port for a gastric band is often attached directly over the rectus abdominis. Further, the fixation of the device is of equivalent or greater strength to sutures and resists becoming dislodged or disconnected in order to accommodate a long-term implant.
  • the invention as described herein may be used with any type of implantable device.
  • FIG. 1-40 the housing is shaped as a ring, and may accordingly be described as such.
  • the shape of the housing is dependent on that of the device, such that the present invention is not limited to devices in which the housing would be circular.
  • the access port 10 includes a septum 11, which in practice is pierced by a needle to input fluid such as saline into the access port for use with, for example, a hydraulic operated gastric band.
  • the access port 10 includes a detachable housing 12 which surrounds the outer perimeter ofthe access port.
  • the housing 12 includes notches or openings 15.
  • the notches house fasteners 14.
  • the notches or openings 15 may take any fo ⁇ n necessary to adequately house the fastener 14 while allowing movement ofthe fastener 14. It is within the scope of the invention that at least three fasteners 14 be present in order to minimize the possibility of movement or dislodgement of the device. As shown in Figs.
  • the fasteners 14 are attached to the ring 12 by a perpendicular segment engaged though a hole and thereby pivotally connected to the ring 12.
  • the fasteners 14 have a first position as shown in Figs. 1 and 3 and a second or secured position as shown in Figs. 2 and 4. To move from the first to the second position, the fastener rotates about an axis of the fastener. The notch 15 accommodates this rotation and a small locking tab holds the fastener in position after rotation.
  • the fasteners 14 may be 2-legged staples.
  • the staples are rigid, such that they do not deform during the rotation into the fascia of a patient. For such applications conventional metals are suitable.
  • the staples may be shaped as a "U" or variations thereof, including substantially shaped as:
  • the fastener 14 When in the second position, the fastener 14 is held rigidly in place by a locking tab 16, and fastener 14 may flex to allow the fastener to pass into the locked position.
  • the formation of the locking tab 16 may be such that upon movement of the fastener 14 from the first to the second position an audible click is heard by the surgeon to indicate that the fastener 14 is fully engaged by the locking tab 16. The click may also be tactile, allowing the surgeon to feel that the fastener is fully engaged by locking tab 16.
  • an access port 10 is secured within the housing 12 in the patient by the fasteners 14 which interface with the fascia ofthe patient. Essentially, the fascia or other bodily tissue is secured between the fasteners 14 and the housing 12 or device 10.
  • the housing 12 may contain pegs (not shown) which engage suture holes (not shown) which surround the perimeter ofthe device 10.
  • Figs. 5-8 depict the access port of Fig. 1 and its interaction with an access port delivery system 20.
  • the access port delivery system 20 may have a fmger depression 25 which is used by the operator to help hold the access port and the delivery system in place and properly aligned.
  • the delivery system 20 comprises a port cover 21.
  • the port cover 21 houses a plunger 22, a slide pusher 24, and a slide assembly 26.
  • the port cover may be formed in any shape necessary to substantially cover the access port 10.
  • the plunger 22 provides the operative means for the delivery system 20 and is connected to a firing means which will be described below.
  • the plunger 22 moves in the direction ofthe access port 10. This movement causes the slide pusher 24 to be actuated.
  • the slide pusher 24 transfers the energy of the moving plunger 22 to the slide assembly 26.
  • the slide assembly 26 has a substantially round shape and encircles the access port 10. In other applications, the slide assembly may take a form suitable to the device and housing to be implanted.
  • the slide assembly 26 is forced in the direction ofthe access port 10. Alignment tabs 30 assist the alignment ofthe slide assembly 26.
  • the alignment tabs 30 are attached to the port cover 21 and interact with the access port 10 to ensure proper alignment.
  • the movement of the slide assembly 26 causes beams 28 attached to the slide assembly 26 to act upon the fasteners 14.
  • Fig. 9 shows an access port delivery system complete with a firing means 40.
  • Fig. 10 shows a cross sectional view ofthe firing means 40 in the starting or loaded position.
  • the firing means has a trigger 50 connected to a lever 52.
  • the spring 42 and rod 46 are in a housing 54.
  • the lever 52 upon application of a predetermined force to the trigger 50, the lever 52 acts on the housing 54.
  • the housing 54 pivots on a fulcrum (not shown), this pivoting action lifts the latch 44 above the end ofthe rib 48.
  • the spring force of the compressed spring 42 drives the plunger 22 in the direction of the access port and actuates the mechanism therearound as discussed above.
  • Fig. 12 shows a palm grip actuated firing mechanism 60.
  • the palm grip is a very simple design requiring only a single moving part to move the plunger 22.
  • a first position as shown in Fig, 13 there is a moving handle 61, a stationary handle 62, a pivot point 64, and an actuating tip 66. In operation the user squeezes on the moving handle 61 forcing it in the direction of the stationary handle 62.
  • This movement forces the actuating tip 66 which is connectively engaged with the moving handle 61 and the pivot point 64 in a direction opposite the direction of movement of the movable handle 61.
  • a comparatively small force applied to the moving handle 61 is amplified through the pivot point 64 and applied by the actuating tip 66 to the plunger 22.
  • the plunger 22 is moved by the actuating tip 66 in the direction of the access port 10 and actuates the mechanism therearound as discussed above.
  • the force produced by the palm grip actuated device is limited only by the strength of the user, as tested the device was capable of producing in excess of 50 lb. of force with a plunger travel of .25 in.
  • a geared mechanism could be produced that could produce equal or greater force although require a greater travel distance for the moving handle 61.
  • the force produced by the device shown in Figs. 12-14 could also be altered as necessary by moving the pivot point 64 nearer the plunger 22 to produce more force, or away from the pivot point to produce less force.
  • Yet another alternative firing means is shown in Figs. 15-19.
  • the pistol grip firing means 70 includes a trigger 72 having geared teeth 73 located on one end, a gear 74 which meshes with the geared teeth 73, a rack 75 driven by the gear 74, and a spring 76.
  • the rack may also include a means 78 for gripping the plunger 22.
  • the operative progression is shown in Figs. 17-19. In Fig.
  • the trigger is extended and the spring is under little or no tension.
  • the geared teeth 73 are meshed with corresponding teeth of the gear 74 and with teeth on the rack 75.
  • the plunger 22 is in the extended position.
  • the geared teeth 73 actuate the gear 74 and in turn cause the rack 75 to compress the spring 76, as shown in Fig. 18.
  • the gear 74 is free to spin.
  • the stored energy in the spring 76 forces the rack 75 to move toward the plunger 22.
  • the free spinning gear 74 allows the rack 75 to move, which in turn forces the plunger towards the access port 10 and actuates the mechanism therearound as discussed above.
  • a lock (not shown), which after the spring 76 is compressed prevents the gear 74 from spinning. Then when desired the operator can release the lock, thereby allowing the spring 76 to expand as discussed above.
  • the pistol grip firing means 70 permits the plunger to travel approximately .4 in and can produce in excess of 50 lb. of force.
  • a further embodiment ofthe present invention is shown. The use of NiTi or SMA alloy materials is well known in the medical arts as discussed above. As shown in Fig.
  • NiTi fasteners are shown in a pre-deployment state.
  • the fasteners 14 are continuous and attached to the access port 10 through holes therein. In operation the fasteners 14 are depressed into the fascia ofthe patient to secure the access port.
  • the NiTi fasteners 14 have the unique ability to change their shape when heated, e.g. to body temperature. As shown in Fig. 21, when the fasteners are deployed they can change shape to bend under the access port 10 and secure it in place.
  • the fasteners 14 are shown with straight legs 80 in a deployed state.
  • Alternative configurations include curved legs 81 as shown in Fig. 23. Using the curved legs 81, the fascia can be pinched between the fastener and the underside ofthe access port.
  • Fig. 24 A further alternative is shown in Fig. 24 where the tips of the fastener legs 81 are coated with a molded tip 82.
  • the molded tip may be formed in a shape that will assist in piercing the fascia of the patient. This eliminates the need to form the fastener 14 into a shape for piercing.
  • the tips 82 may be formed of a bio-absorbable material.
  • the NiTi fastener can be continuously formed in a ring 84. The use of the ring 84 allows for the fasteners 14 to be formed with a continuous construction. After the ring 84 with the fasteners 14 is formed, the ends of the legs 80 can be ground off to produce individual substantially U-shaped fasteners 14.
  • the ring 84 insures that the fasteners 14 can be inserted as a unit as discussed above, and the grinding ofthe legs ensures a sufficiently sharp point to pierce the fascia.
  • the legs can be formed and positioned in the ring 84 so that after bending due to heating, the legs 80 face internally to the access port 10 or externally to the access port 10.
  • Yet another embodiment of the present invention is a two-part fastening system as shown in Figs. 28-34.
  • Fig. 28 shows a guide 90 formed with a plurality of individual fasteners 14. The fasteners 14 are slidable in the guide 90 from a first to a second position. In operation the guide 90 is placed over the access port 10 and aligned with notches 15.
  • the fasteners 14 are formed of a spring like material and shaped to attach to the access port 10.
  • the fasteners 14 are slid from a first position as shown in Fig. 28 to a second position as shown in Fig. 29.
  • the fasteners 14 pierce the fascia and securely hold the access port 14 thereto.
  • the fasteners may have straight or curved legs.
  • the guide may be removed if it is not part ofthe final implanted device.
  • the guide 90 may also be a permanent part ofthe implantable device.
  • a further two-part fastening device includes a pre-formed ring 100 (Fig. 31 and Fig. 32).
  • the ring includes a first securing means 104 for attaching the ring 100 to the fascia.
  • the ring also includes a second securing means 102 for attaching an access port 10 to a secured ring 100.
  • the ring 100 is placed upon the fascia and then twisted to engage the fascia in the first securing means 104.
  • the access port 10 is then placed upon the ring 100 and engages the second securing means 102 via holes 106 in the access port.
  • This design allows for positive attachment and re-installation repeatability without disengaging the pre-formed ring.
  • Fig. 33 and Fig. 34 depict yet another two-part fastening device comprising an applicator 112 and a ring 110 having NiTi fasteners 114.
  • the ring 110 is inserted into the applicator 112.
  • the applicator 112 is placed over the access port 10 with the fasteners 114 aligned with notches 115 and holes 106.
  • the fasteners 114 are forced through the holes 106 and engage the fascia of the patient upon which the access port 10 rests. Through the heating process, the fasteners 114 change shape and secure the access port to the fascia. After a predetermined time, the applicator can be removed.
  • Another embodiment of the present invention regards stand alone fasteners. As shown in Figs. 35-38, a variety of designs can be used to secure an access port 10 to the fascia of a patient.
  • the fasteners may incorporate NiTi so that the fasteners change shape upon application of a predetermined amount of heat.
  • These fasteners 14 may be inserted singularly, or as part of a pre-formed ring as discussed above. When inserted singularly, the fasteners 14 may be straight rods or may have some pre-formed shape which may be heightened through the heating process.
  • the fastener 14 takes on a curly, pig-tail shape.
  • the fastener takes on a substantially C-shaped appearance.
  • Figs. 37 and 38 use U-shaped fasteners 14, the ends of which bend, linearly when heated to form an omega shape as shown in Fig. 37, or perpendicularly to the shape as shown in Fig. 38.
  • FIG. 39 Yet another embodiment ofthe present invention is shown in Fig. 39.
  • the fasteners 14 are slidably installed in the access port 10. This may be accomplished by cold molding of the NiTi fastening system into the device, and allows positive attachment and repeatable re-positioning.
  • an installation tool 120 Through the use of an installation tool 120, the fasteners are forced through holes in the bottom of the access port 10 and engage the fascia. By installing the fasteners as an integral part ofthe access port 10, no ring or housing is needed as discussed above for housing the fasteners.
  • the installation tool 120 could be part of a triggering device as disclosed herein.
  • Fig. 40 shows the fastener 14 in the engaged position.
  • radial pivot fasteners are a simple delivery system, with direct drive.
  • the associated delivery system actuates the pivot for radial entry.
  • the staple may be stainless steel, titanium, Nitinol or ElgiloyTM, or other suitable materials including other metals or plastics.
  • the molded pivot/lock-out system may be designed to snap into the existing suture holes on implantable devices.
  • the simple staple shape allows for easy manufacturability. Such a system is self-puncturing, i.e. no pre-puncturing of the bodily tissue, e.g. fascia, is necessary.
  • the curved nature of the staple allows the penetration into the bodily tissue as the staple advances to be predictable; and the pivoting nature of the curved staple generates an easy path through the tissue. Removal of the fastening system requires an extraction tool, and the staples will rotate out ofthe original entry path with only small resistance from ingrown surrounding tissue. However, the force required to remove the system is adequate to allow the staples to remain locked in position except during a removal procedure.
  • Continuous wire forms of the fastener system contemplated herein include blunt tips, molded tips, and ground or chopped tips. Blunt tip continuous wire systems, as shown in Figures 20-23 may require pre-puncture for insertion of the blunt tipped wire.
  • the fastener assembly may be manufactured to require the locking feature to retain either the wire form or the overmolded ring.
  • the simple wire form may be made of stainless steel, titanium, ElgiloyTM, NiTi or other suitable materials. Removal of the fastener assembly may be done easily due to the blunt ends, which provide minimal tissue damage and trauma. Additionally, the blunt tip reduces the force necessary to remove the assembly.
  • the continuous wire form assembly with molded tips, shown in Figures 20 and 24, does not require pre-puncture ofthe bodily tissue, and these tips allow for easy entry into the bodily tissue. Further, the chopped or ground blunt end continuous wire form assembly, Figures 25-27, also requires no pre-puncture of the bodily tissue, which also allows for easy entry into the tissue.
  • the radial slide fastener assembly depicted herein with flat fasteners ( Figures 28 and 29) and curved fasteners ( Figure 30), requires a larger entry site than the other fastener assemblies.
  • the fasteners create a path through the bodily tissue that is simple and secure, with added retention in systems utilizing the curved fasteners. Removal of the systems is accomplished with an associated extraction tool that withdraws each fastener from their center position. Alternatively, the fasteners may be manufactured such that removal may be accomplished by lifting the assembly upwards, at which time the fasteners bend to a straightened position, allowing for easy removal. Fig.
  • a helical coil fastener 201 which may optionally be utilized with a port that features a tubing connector extending from the center ofthe base.
  • the corkscrew- type design is mounted to a separate disc 203 which snaps to the port at tabs 202, or alternatively may be mounted to the port itself, centered on the base plate.
  • the disc or port is manually affixed to the tissue by rotation of the disc or port, which causes the coil to travel on a helical path through the tissue.
  • the coil can have a sharpened tip.
  • a variation of the helical coil fastener is depicted in Fig. 42.
  • Fig. 42 depicts a flat spiral spring 204 that is deflected downward to begin its path through the tissue.
  • the deflecting implement 205 may be withdrawn following implantation, allowing the spring to compress during healing. Compression of the spring will reduce the profile of the implanted coil fastener and can reduce the likelihood of pain induction.
  • Tabs 202 are used for locking a port or other device into the fastener.
  • Figures 43-47 and Figure 55 depict a horizontal coil implantation system. In the horizontal coil system, a metal coil is used horizontally to stitch the port to the tissue. It is well known that such coils can pierce and hold in tissues from their use as mesh tacks in minimally invasive hernia procedures. In this case, the coil travels parallel to the tissue surface instead of perpendicularly, as in the helical coil fasteners described above.
  • a small deployment tool 206 is envisioned to aid in driving the coil 208 through the tissue and the mating holes 207 in the base coil receptacle 209 (see Figs. 46 and 47).
  • Such holes could be straight holes through a ridge on the bottom ofthe base (see Figs. 44, 45 and 47), or curved holes molded into a flat-surfaced base.
  • a top view of a base is shown in Fig. 43. It is envisioned that the last hole would be blind, and that the end ofthe coil would be shaped in a crossbar that could slide over an incline and lock into place, such as into a slot.
  • a variation would feature a path for the coil that curves around the port or base edge, facilitating tool access to the coil.
  • FIGs. 48 to 62 depict various embodiments of a metal suture system.
  • This method of port fixation involves the creation of one or multiple closed metal loops below the port base, by using the base itself as a means to close a loop formed by curved metal members (see, e.g. Figs. 48 and 52).
  • Figure 48 illustrates one closed loop, with a single curved metal member shown in its post-deployment position.
  • Figure 49 is a cutaway top view of one embodiment of the invention showing the curved metal members 211 in their pre- deployment position.
  • Figure 57 depicts both a bottom and side view of one embodiment of the invention showing the curved metal members forming a loop with the bottom of the base.
  • Figure 51 shows curved metal members, with the arrows indicating their deployment rotation.
  • Fastening of a port in the above described manner may be done both with one- piece and two-piece systems, whereby a two-piece system may have a ring 210 that attaches to the port or other device by snap-fitting with tabs 202 as shown in Fig. 50.
  • One embodiment includes a deflection tool to separate the point of the metal member from contact with the base allowing the member tip to begin its path downward through the tissue. This can be a circular disc or the port itself.
  • another embodiment includes multiple members curved in two planes, such that rotation ofthe base affects the creating of multiple loops.
  • An alternate method to achieve such a loop is with a curved pin 212 that is inserted through the base after it is in its intended tissue location, as seen in Figs. 53 and 54.
  • Such a pin by nature follows an arc through the tissue and can easily be directed back to the port base.
  • Such a pin can be made to lock in place after full travel by adding a right angle bend 213 to the pin that snaps into a slot 214 on the base, or other such well-known means.
  • a variation on this theme includes an additional straight section on the end ofthe pin, parallel to the curved section.
  • a lever arm 215 is used to drive the curved section through the base and to the completion of its intended travel.
  • a two-piece system may be used wherein the port attaches to a folding baseplate 218 with sharp, curved extensions 217 (see Fig. 56). The folded plate is placed on the tissue with the extensions pointed toward the tissue. When the baseplate is unfolded (flattened) the extensions are driven 90 degrees in a rotary path (see Fig. 56). The port is then snapped to the baseplate, locking the extensions in position. In one embodiment, the points ofthe extensions would overlap those from the other half, semi- shielding the points. Figs.
  • the device to be implanted is secured to the tissue using a plurality of curved pins or hooks 501 (Fig. 62), the tips of which rotate through an arc and are received back in or near the baseplate 510 at the end of their travel.
  • a disc 520 within the baseplate 510 rotates, thereby causing lever arms 525 to push against curved hooks 501, which in turn rotate about their fixed axis in the baseplate through an arc until the rotational travel ofthe disc stops.
  • the tips of hooks 501 are preferably received back in baseplate 510 to form a closed loop.
  • the tips may form less than a closed loop.
  • the rotating disc 520 locks in place at the end of its travel to lock the hooks in place.
  • One-way flexible locking tabs 527 that engage stops 515 or other locking means may be used to lock the hooks in place by preventing backward rotation ofthe disc.
  • a deployment tool or delivery system such as that described above with reference to Figures 5-19 may be used to fasten the device in place.
  • the linear motion ofthe plunger 22 and slide pusher 24 is converted into rotational motion through a transmission using gearing or other well known means.
  • Figures 63-72 illustrate a preferred access port delivery system.
  • lever 605 is attached to handle 607 at hinge 621.
  • Cable sheath 619 is secured to handle 607 by securing pin 623.
  • Cable sheath 619 encloses cable 617 which is attached to lever 605 at the handle end ofthe device at cable stop 615. Cable sheath 619 allows the linear motion of cable 617.
  • actuator lever 701 is snapped into port cover 631.
  • actuator lever 701 and port cover 631 have curved lips 721 for gripping the baseplate of a disc fastener.
  • actuator lever 701 has groove 723 to allow the actuator lever to rotate around the baseplate with minimal contact, the only contact being from curved lip 721.
  • Figure 66 shows edge 713 of the actuator lever, which snaps into a matching groove of port cover 631 and secures the actuator lever but allows its rotational motion.
  • Figure 65 shows a top view of the actuator lever, and shows cable stop 705, where the deployment end of cable 617 is attached. Cable 617 runs through slot 707 and out through notch 709 and along groove 711. When the user ofthe deployment tool pulls lever 605 towards handle 607, cable 617 is pulled through the sheath towards handle 607.
  • Figures 69 and 70 show partially exploded and cutaway detail ofthe various parts ofthe actuator lever, port cover and cable assembly.
  • Figures 71 and 72 show an embodiment of port cover 631 in greater detail. Attachment position 735 is the location where a cable sheath may attach to the port cover.
  • both Figures 71 and 72 show device passageway 737.
  • Device passageway 737 allows a port cover to be attached to a port or other device without interfering with any tubing or other instrumentation that may be running from the port or device.
  • the passageway is a square shape, however the passageway may be in a wide variety of shapes to accommodate a variety of devices.
  • Figures 73 - 77 depict a loading fixture for holding a combined port/disc fastener assembly. The port/disc fastener system is snapped into the fixture, which protects the assembly, protects the user from accidental contact with the hooks, sharpened points, etc., used to fasten the assembly to tissue, prevents premature deployment of the assembly, and allows the user to load the port/disc fastener system into the deployment tool without actually touching the assembly.
  • the deployment tool is snapped onto the assembly while it is still in the loading fixture. Similar to the device passageway ofthe port cover, the loading fixture has device passageway 739 to allow any tubing to hang freely from the device to be attached without any interference from the loading fixture.
  • Figure 75 shows how a device may be securely held in place by locking tabs 743 and/or pegs 741.
  • Figure 76 shows a port/disc fastener assembly being held securely by the loading fixture.
  • Figure 77 shows an exploded view ofthe disc fastener/loading fixture assembly without a port device attached.
  • FIG. 58-62 A brief description ofthe combined use of preferred embodiment ofthe disc fastener system shown in Figures 58-62, the preferred embodiment of the deployment tool of Figures 63-68 and the loading fixture of Figures 73-77 is helpful in understanding the invention.
  • the user grasps the port delivery system at handle 607.
  • the port/disc fastener assembly would be held in the loading fixture, as shown in Figure 76.
  • the user maneuvers the port cover 631 over the port/disc fastener assembly, and curved lips 721 ofthe actuator lever and port cover snap-fit with the baseplate 510, such that an audible and tactile click is heard and felt by the user.
  • the user then pulls the deployment tool from the loading fixture with the combined port/disc fastener attached and ready to be deployed.

Abstract

A surgical fastening system for implantable devices is disclosed. The implantable device may contain a plurality of fasteners in pre-deployment position, may have a housing fitted over or around fit which contains a plurality of fasteners in pre-deployment position, or may be a part of a two-part system into which it its. Accordingly, the present invention also encompasses a deployment system or tool that optionally positions the implantable device, and which causes the fasteners to move into post-deployment position. The fasteners may be staples, metal loops, coils, springs or hooks formed of biocompatible materials, including shape memory alloys such as NiTi.

Description

IMPLANTABLE DEVICE FASTENING SYSTEM AND METHODS OF USE
BACKGROUND OF THE INVENTION 1. FIELD OF THE INVENTION The present invention relates to the fields of implantable medical devices and surgical instruments and fasteners. The present invention encompasses methods of fastening devices or implants in surgical procedures and the surgical fasteners and instruments used in the process. 2. DESCRIPTION OF THE RELATED ART Surgical fasteners such as staples, clips, clamps, bands, tacks, or other wound or incision closure devices are commonly used in surgical procedures to allow a surgeon to fasten, secure and/or repair body tissue. Examples of surgical fasteners are given in U.S. Pat. Nos. 4,994,073 or 4,950,284 or 4,934,364 and 4,932,960. Surgical fasteners have been used in surgical procedures to eliminate the need for suturing, which is both time consuming and inconvenient. In these applications the surgeon often uses a fastener implanting device loaded with one or more surgical fasteners to accomplish in a few seconds what would have taken many minutes to perform by suturing. This reduction in operating time reduces blood loss and trauma to the patient. Typically, such fastening systems have been used mainly for the closure of incisions or wounds, or to fasten tissues together. A surgical fastening system that could be used with a number of types of implantable devices would be beneficial for surgeons. Currently, surgical devices that incorporate fastening systems often use extremely specialized systems that may be unnecessarily complicated and are unsuitable for adaptation to other applications. As a result, the majority of implantable devices are secured with sutures. For example, when inserting a gastric band and the associated access port, .the port is sutured into place with 4 to 5 sutures against the rectus muscle sheath. Such placement of the sutures is often challenging because the ports are placed below several inches of fat, and suturing the port often takes as long as placing the band itself. An improved fastening system would allow easy, one-step attachment with security equivalent to the sutured device. The present invention overcomes such problems in the art. SUMMARY OF THE INVENTION The present invention encompasses surgical fastening systems wherein an implantable device either contains a plurality of fasteners in pre-deployment position, or wherein an implantable device may have a housing fitted over the device, wherein the housing contains a plurality of fasteners in pre-deployment position. Accordingly, the present invention also encompasses a deployment system that optionally positions the implantable device, and which causes the fasteners to move into post-deployment position.
BRIEF DESCRIPTION OF THE DRAWINGS The above objects and advantages of the present invention will be more fully understood by reference to the following description and annexed drawings, in which: Figure 1 is an elevation view of a radial pivot fastener with staples in pre- deployment position; Figure 2 is an elevation view of the radial pivot fastener of Figure 1 with staples in deployed position; Figure 3 is a detail elevation view of the radial pivot fastener of Figure 1 with staples in pre-deployment position; Figure 4 is a detail elevation view of the radial pivot fastener of Figure 2 with staples in deployment position; Figure 5 is an elevation view of a delivery system; Figure 6 is a cutaway view of the delivery system shown in Figure 5 and a port fastener; Figure 7 is a detail cutaway elevation view ofthe distal end ofthe delivery system of Figure 6 and a port fastener in pre-deployment position; Figure 8 is a detail cutaway elevation view ofthe distal end ofthe delivery system of Figure 6 and a port fastener in deployment position; Figure 9 is an elevation view of a pencil grip handle configuration for a delivery system; Figure 10 is a detail cutaway elevation view of the handle ofthe delivery system of Figure 9 shown in a starting position; Figure 11 is a detail cutaway elevation view ofthe handle of the delivery system of Figure 9 shown in a fired position; Figure 12 is an elevation view of a pistol grip handle configuration for a delivery system; Figure 13 is a detail elevation view ofthe handle ofthe delivery system of Figure 12 shown in a starting position; Figure 14 is a detail elevation view ofthe handle ofthe delivery system of Figure 12 shown in a fired position; Figure 15 is an elevation view of another pistol grip handle configuration for a delivery system; Figure 16 is a detail view of the gear train mechanism of the delivery system of Figure 15; Figure 17 is a detail cutaway elevation view o the delivery system of Figure 15 shown in a starting position; Figure 18 is a detail cutaway elevation view of the delivery system of Figure 15 shown in a full spring recoil position; Figure 19 is a detail cutaway elevation view of the delivery system of Figure 15 shown in a fired position; Figure 20 is an elevation view of a continuous NiTi wire form fastener in pre- deployment position; Figure 21 is an elevation view of the continuous NiTi wire form fastener of Figure 20 in post-deployment position; Figure 22 is a bottom elevation view of a straight leg, blunt tip continuous wire form fastener; Figure 23 is a bottom elevation view of a curved leg, blunt tip continuous wire form fastener; Figure 24 is a bottom elevation view of a molded tip continuous wire form fastener; Figure 25 is an elevation view of a continuous NiTi wire form fastener with grounds tips in post-deployment external position; Figure 26 is an elevation view of a continuous NiTi wire form fastener with grounds tips in post-deployment internal position; Figure 27 is a bottom elevation view ofthe continuous NiTi wire form fastener with grounds tips of Figure 26 in post-deployment internal position; Figure 28 is an elevation view of a radial slide fastener with straight legs and a staple guide; Figure 29 is an elevation view ofthe radial slide fastener of Figure 28; Figure 30 is an elevation view of a radial slide fastener with curved legs; Figure 31 is an elevation view of a two-part fastening system before installation; Figure 32 is an elevation view of the two-part fastening system of Figure 31 after installation; Figure 33 is an elevation view of another two-part fastening system before installation; Figure 34 is an elevation view of the two-part fastening system of Figure 33 after installation; Figure 35 is an elevation view of a stand-alone fastener incorporated into a device; Figure 36 is an elevation view of another stand-alone fastener incorporated into a device; Figure 37 is an elevation view of another stand-alone fastener incorporated into a device; Figure 38 is an elevation view of another stand-alone fastener incorporated into a device; Figure 39 is an elevation view of another stand-alone fastener incorporated into an injection port in a pre-installation position; Figure 40 is an elevation view of the stand-alone fastener of Figure 39 in a post- installation position; Figure 41 is an elevation view of a helical coil fastener; Figure 42 is an elevation view of another helical coil fastener; Figure 43 is a top view of a horizontal coil fastening system base; Figure 44 is a side view ofthe horizontal coil fastening system base of Figure 43; Figure 45 is a bottom view ofthe horizontal coil fastening system base of Figure 43; Figure 46 is an elevation view of a driver tool of a fastening system for the horizontal coil fastening system of Figure 43; Figure 47 is a detail view ofthe horizontal coil fastening system base of Figure 43. Figure 48 is a side view of a closed metal loop fastening system incorporated into a device; Figure 49 is a top view of device incorporating the closed metal loop fastening system of Figure 48; Figure 50 is a side view of a two-part snap fit fastening system. Figure 51 is an elevation view of a another closed metal loop system using curved pins or hooks; Figure 52 is a side view of the closed metal loop system using the curved pins or hooks of Figure 51 incorporated into a device; Figure 53 shows top and side views of a curved pin fastening system incorporated into a device; Figure 54 shows top and side views of another curved pin fastening system incorporated into a device; Figure 55 shows bottom and side view of a spring screw fastening system; Figure 56 shows side view of a folding baseplate with curved fasteners in its open and closed positions; Figure 57 shows top and side views of rotating hook fasteners incorporated into a device; Figure 58 is a top elevation view of a rotating disc fastening system with fasteners in pre-deployment position; Figure 59 is a bottom elevation view of the rotating disc fastening system of Figure 58 with fastener in post-deployment position; Figure 60 is a bottom view of the rotating disc fastening system of Figure 58 with fasteners in post-deployment position; Figure 61 is a side view of the rotating disc fastening system of ?Figure 58 with fasteners partially deployed; and Figure 62 is an elevation view of the curved fastener of the rotating disc fastening system of Figure 58 showing the axis of rotation. Figure 63 is cutaway side view of a delivery system. Figure 64 is a side elevation view of a delivery system. Figure 65 is a top view ofthe actuator lever ofthe delivery system of Figures 63 and 64. Figure 66 is a side view of the actuator lever of the delivery system of Figures 63 and 64. Figure 67 is a bottom view ofthe actuator lever ofthe delivery system of Figures 63 and 64. Figure 68 is a side elevation view of the actuator lever of the delivery system of Figures 63 and 64. Figure 69 is a partially exploded and cutaway view ofthe port cover ofthe delivery system of Figures 63 and 64. Figure 70 is a partial cutaway view of the port cover of the delivery system of Figures 63 and 64. Figure 71 is a back view ofthe port cover ofthe delivery system of Figures 63 and 64. Figure 72 is an elevated side view ofthe port cover ofthe delivery system of Figures 63 and 64. Figure 73 is an elevated bottom view of a loading fixture. Figure 74 is a bottom view of a loading fixture. Figure 75 is an elevated view of a loading fixture. Figure 76 is an elevated view of a disc fastener/port/loading fixture assembly. Figure 77 is an exploded view of a disc fastener/loading fixture assembly. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention encompasses surgical fastening systems wherein an implantable device either contains a plurality of fasteners (e.g. staples) in pre-deployment position, or wherein fasteners are provided adapted to suture holes on the device, or wherein an implantable device may have a detachable housing fitted over the device, wherein the housing contains a plurality of fasteners in pre-deployment position. The detachable housing and fasteners may be made of various materials known in the art for the manufacture of surgical fasteners and implants. The fasteners may be made of metal, polymer, or other suitable materials. The detachable housing may be made of metal, polymer, ceramic, or composites; for instance polysulfone, acetyl copolymers, titanium, elastomers and stainless steel are commonly used. These materials must be biocompatible, i.e., they do not adversely affect the surrounding living environment, and conversely, their performance is not adversely affected by the surrounding living environment. The materials may be inert non-absorbable or biodegradable. Inert materials may be fairly indestructible and maintain their form and function for extended periods of time. Metals and metal alloys, and particularly titanium and titanium alloys, are used for a great variety of implantable articles for medical applications. All implantable articles suffer from some degree of bio-incompatibility, which may be manifested as tissue inflammation, necrosis, hyperplasia, mutagenicity, toxicity, and other reactions, such as attack by giant cells, leukocytes and macrophages. While titanium and its alloys are generally considered inert when implanted, some biological and biochemical interactions still may occur, and others have found it desirable to provide various coatings on the surface of titanium and titanium alloy implants for certain purposes. The same holds true for many other metals and metal alloys. Thus, the present invention encompasses the use of such coatings on the surface ofthe fasteners, the removable housing, or the device. Some of the coatings that may be used in materials to be implanted (whether made of titanium or other materials) include biological agents (such as genetic material or cellular material) or chemical agents (such as anti-proliferation reagents or cell-growth factors) to reduce problems associated with hyperplasia or inflammation. These agents may be mixed with binders such as elastomers or bio-resorbable polymers to the surface of a metal or polymer object. The fasteners contemplated herein, including staples, are often constructed of wire and thus have a relatively large surface area for their size. Accordingly, methods that allow the addition of biological and biochemical agents to the surface of the implant may be advantageous in minimizing the adverse reactions of body tissues with the implant. These may include coatings applied to stainless steel and titanium alloys (e.g., NiTi alloys) to retard tissue reactions. Such coatings have been based upon stable bio-compatible polymers (such as styrene-isobutylene-styrene (SIBS)) and bio-resorbable polymers, such as polyglycolic acid. In the work known to date, the active chemical or biological agent is mixed with the polymeric coating material, and the agent then elutes from the coating once the implant is placed in the body. It is also contemplated by the present invention that the fasteners may be made of shape memory alloy (SMA). The driving force for making metal medical devices from shape memory alloys lies in their great resistance to permanent deformation as compared to conventional alloys employed in this application. Alloys used in various medical instruments have relied on stainless steel, high nickel alloys such as Elgiloy™ and titanium based alloys, all of which can be given quite high yield strength through work hardening. Normal metals, even with very high yield strength, cannot sustain strains much greater than 0.2% without suffering a permanent set. Once a bend or kink has been sustained in a device fabricated from one of the above conventional alloys it is virtually impossible to remove. The unusual property of pseudoelasticity exhibited by shape memory alloys such as Au~Cd, Cu~Zn~Al, Ni~Ti and many others makes possible the complete "elastic" recovery of strains as great as 10%. Due to its high recoverable strain and its excellent resistance to corrosion, the shape memory alloy of preference for medical components has been within the Ni~Ti family of alloys. Shape memory alloys belong to a class which exhibit thermoelastic martensite transformation. The term martensite refers to the crystalline phase which is produced in steels when quenched from a high temperature. The phase which exists at the elevated temperature is referred to as austenite; these terms have been carried over to describe the transformations which occur in shape memory alloys. When a steel has been quenched from the austenitic temperature to martensite, to again form austenite requires heating the structure to quite high temperatures, usually in excess of 1400° F. By contrast, the thermoelastic shape memory alloys can change from martensite to austenite and back again on heating and cooling over a very small temperature range, typically from 18 to 55° F. The transformation of a shape memory alloy is usually described by a hysteresis curve in which it is shown that on cooling from the austenitic phase, often called the parent phase, martensite starts to form at a temperature designated as Ms and upon reaching the lower temperature, MF, the alloy is completely martensitic. Upon heating from below the MF temperature, the martensite starts to revert to the austenitic structure at As, and when the temperature designated as AF is reached, the alloy is completely austenitic. These two phases or crystalline structures have very different mechanical properties: the Young's Modulus of austenite is ~12xl 06 psi, while that for martensite is ~4xl 06 psi; and the yield strength, which depends on the amount of cold work the alloy is given, ranges from 28 to 100 ksi for austenite and from 10 to 20 ksi for martensite. The unique feature of shape memory alloys is their ability to recover deformation. When a shape memory alloy specimen, in its martensitic form is subjected to stress, the strain is accommodated by the growth and shrinkage of individual martensite variants rather than by the mechanisms which prevail in conventional alloys: slip, grain boundary sliding and dislocation motion. When deformed martensite is heated to the austenite finish temperature AF, the part reverts to its original undeformed state. Thus, for medical implant uses, it is possible to develop a design where the device is stored below body temperature in its unformed shape, and upon insertion into the body, the temperature ofthe device raises to that of the body, at which point the device reverts to the austenitic structure. In the instant application, the fasteners may be optionally made of an S?MA such as NiTi. It is within the scope ofthe present invention that such fastening systems as herein described are able to be fastened into bodily tissue in less time than would be required to suture the device into place. In the instance described here (the placement of an access port for a gastric band), the placement and fixation ofthe fastening system should take no more than five minutes. Additionally, the fixation system is able to be entirely unfastened and removed from the tissue in order to facilitate repositioning of the device, or to remove the implanted device entirely. Such implantation and extraction will not cause increased trauma to the patient, and the fixation system will not cause more adhesions than the traditional suturing method. The average surgeon or other health professional is reliably and consistently able to perform fixation and extraction ofthe fastening system. Additionally, during the manufacture of such fixation systems described herein, the size ofthe fasteners determines the depth into the bodily tissue into which the fasteners will deploy. In the instant case, fixation of an access port should occur at a depth below the device not to exceed 3mm. Also, in such a use, the bodily tissue into which the fasteners are deployed is the fascia. However, it is within the scope of the invention that the bodily tissue to which the device is attached will vary depending on the specific device. Additionally, the attachment ofthe fastening system into tissue will not cause tissue damage during placement or during body motion; for example, an access port for a gastric band is often attached directly over the rectus abdominis. Further, the fixation of the device is of equivalent or greater strength to sutures and resists becoming dislodged or disconnected in order to accommodate a long-term implant. The invention as described herein may be used with any type of implantable device. Examples of such would include internal monitors, ports, pacemakers, therapeutics, drug delivery systems, neurostimulators, orthopedic devices, tendon repair, etc. For ease of explanation, the invention will now be described as depicted in Figures 1-40, wherein the invention is shown used in conjunction with an access port. One of skill in the art will recognize that the present invention may be used with other types of implantable devices, and that the invention may take other forms analogous to those depicted herein. Additionally, in the accompanying figures, the housing is shaped as a ring, and may accordingly be described as such. However, one of skill in the art will recognize that the shape of the housing is dependent on that of the device, such that the present invention is not limited to devices in which the housing would be circular. Fig. 1 depicts an access port fastening system according to one embodiment of the present invention. The access port 10 includes a septum 11, which in practice is pierced by a needle to input fluid such as saline into the access port for use with, for example, a hydraulic operated gastric band. The access port 10 includes a detachable housing 12 which surrounds the outer perimeter ofthe access port. The housing 12 includes notches or openings 15. The notches house fasteners 14. The notches or openings 15 may take any foπn necessary to adequately house the fastener 14 while allowing movement ofthe fastener 14. It is within the scope of the invention that at least three fasteners 14 be present in order to minimize the possibility of movement or dislodgement of the device. As shown in Figs. 1-4, the fasteners 14 are attached to the ring 12 by a perpendicular segment engaged though a hole and thereby pivotally connected to the ring 12. The fasteners 14 have a first position as shown in Figs. 1 and 3 and a second or secured position as shown in Figs. 2 and 4. To move from the first to the second position, the fastener rotates about an axis of the fastener. The notch 15 accommodates this rotation and a small locking tab holds the fastener in position after rotation. In one embodiment, the fasteners 14 may be 2-legged staples. In another embodiment, the staples are rigid, such that they do not deform during the rotation into the fascia of a patient. For such applications conventional metals are suitable. Furthermore, the staples may be shaped as a "U" or variations thereof, including substantially shaped as:
When in the second position, the fastener 14 is held rigidly in place by a locking tab 16, and fastener 14 may flex to allow the fastener to pass into the locked position. The formation of the locking tab 16 may be such that upon movement of the fastener 14 from the first to the second position an audible click is heard by the surgeon to indicate that the fastener 14 is fully engaged by the locking tab 16. The click may also be tactile, allowing the surgeon to feel that the fastener is fully engaged by locking tab 16. When in the second position an access port 10 is secured within the housing 12 in the patient by the fasteners 14 which interface with the fascia ofthe patient. Essentially, the fascia or other bodily tissue is secured between the fasteners 14 and the housing 12 or device 10. Furthermore, the housing 12 may contain pegs (not shown) which engage suture holes (not shown) which surround the perimeter ofthe device 10. Figs. 5-8 depict the access port of Fig. 1 and its interaction with an access port delivery system 20. As shown in Fig. 5, the access port delivery system 20 may have a fmger depression 25 which is used by the operator to help hold the access port and the delivery system in place and properly aligned. The delivery system 20 comprises a port cover 21. The port cover 21 houses a plunger 22, a slide pusher 24, and a slide assembly 26. The port cover may be formed in any shape necessary to substantially cover the access port 10. The plunger 22 provides the operative means for the delivery system 20 and is connected to a firing means which will be described below. Upon actuation of the firing means the plunger 22 moves in the direction ofthe access port 10. This movement causes the slide pusher 24 to be actuated. The slide pusher 24 transfers the energy of the moving plunger 22 to the slide assembly 26. The slide assembly 26 has a substantially round shape and encircles the access port 10. In other applications, the slide assembly may take a form suitable to the device and housing to be implanted. Upon actuation, the slide assembly 26 is forced in the direction ofthe access port 10. Alignment tabs 30 assist the alignment ofthe slide assembly 26. The alignment tabs 30 are attached to the port cover 21 and interact with the access port 10 to ensure proper alignment. The movement of the slide assembly 26 causes beams 28 attached to the slide assembly 26 to act upon the fasteners 14. The imparting of force on the fasteners 14 allows them to rotate in the ring holes (not shown) and to transcribe an arc defined substantially by the notch 15. This rotation coincides with a movement from the first to the second position discussed above. As the beams 28 continue to be moved towards the access port 10, the fasteners 14 reach the second position and are held in place by the locking tabs 16. In this position the access port 10 is rigidly held in place by the fasteners 14 and their interaction with the fascia or other tissue ofthe patient. Fig. 9 shows an access port delivery system complete with a firing means 40. Fig. 10 shows a cross sectional view ofthe firing means 40 in the starting or loaded position. In this position, the spring 42 is compressed, and a latch 44 that is connected to a rod 46 is secured by a rib 48 to prevent the compressed spring 42 from expanding. The firing means has a trigger 50 connected to a lever 52. As shown in Fig. 10 the spring 42 and rod 46 are in a housing 54. As shown in Fig. 11, upon application of a predetermined force to the trigger 50, the lever 52 acts on the housing 54. The housing 54 pivots on a fulcrum (not shown), this pivoting action lifts the latch 44 above the end ofthe rib 48. Upon lifting, the spring force of the compressed spring 42 drives the plunger 22 in the direction of the access port and actuates the mechanism therearound as discussed above. In such a configuration the plunger travel, speed and impact force can be determined to meet the application needs. As tested, the plunger travel was between .25 and .75 in, and can develop up to 50 lb. of force on the plunger, depending upon the spring used in the application. An alternative to the spring driven mechanism is shown in Fig. 12. Fig. 12 shows a palm grip actuated firing mechanism 60. The palm grip is a very simple design requiring only a single moving part to move the plunger 22. In a first position as shown in Fig, 13, there is a moving handle 61, a stationary handle 62, a pivot point 64, and an actuating tip 66. In operation the user squeezes on the moving handle 61 forcing it in the direction of the stationary handle 62. This movement forces the actuating tip 66 which is connectively engaged with the moving handle 61 and the pivot point 64 in a direction opposite the direction of movement of the movable handle 61. Through the use of the simple lever action, a comparatively small force applied to the moving handle 61 is amplified through the pivot point 64 and applied by the actuating tip 66 to the plunger 22. The plunger 22 is moved by the actuating tip 66 in the direction of the access port 10 and actuates the mechanism therearound as discussed above. The force produced by the palm grip actuated device is limited only by the strength of the user, as tested the device was capable of producing in excess of 50 lb. of force with a plunger travel of .25 in. Alternatively, a geared mechanism could be produced that could produce equal or greater force although require a greater travel distance for the moving handle 61. The force produced by the device shown in Figs. 12-14 could also be altered as necessary by moving the pivot point 64 nearer the plunger 22 to produce more force, or away from the pivot point to produce less force. Yet another alternative firing means is shown in Figs. 15-19. The pistol grip firing means 70 includes a trigger 72 having geared teeth 73 located on one end, a gear 74 which meshes with the geared teeth 73, a rack 75 driven by the gear 74, and a spring 76. The rack may also include a means 78 for gripping the plunger 22. The operative progression is shown in Figs. 17-19. In Fig. 17, the trigger is extended and the spring is under little or no tension. The geared teeth 73 are meshed with corresponding teeth of the gear 74 and with teeth on the rack 75. The plunger 22 is in the extended position. When the trigger 72 is depressed, the geared teeth 73 actuate the gear 74 and in turn cause the rack 75 to compress the spring 76, as shown in Fig. 18. At a predetermined distance the geared teeth 73 no longer engage the gear 74. At this point the gear 74 is free to spin. The stored energy in the spring 76 forces the rack 75 to move toward the plunger 22. The free spinning gear 74 allows the rack 75 to move, which in turn forces the plunger towards the access port 10 and actuates the mechanism therearound as discussed above. Another feature which may be incorporated into the pistol grip firing means 70 is a lock (not shown), which after the spring 76 is compressed prevents the gear 74 from spinning. Then when desired the operator can release the lock, thereby allowing the spring 76 to expand as discussed above. As tested, the pistol grip firing means 70 permits the plunger to travel approximately .4 in and can produce in excess of 50 lb. of force. One distinct advantage of this embodiment over, for example, the movable grip device discussed above is the instantaneous deployment having a very high impact speed. In Fig. 20 a further embodiment ofthe present invention is shown. The use of NiTi or SMA alloy materials is well known in the medical arts as discussed above. As shown in Fig. 20 NiTi fasteners are shown in a pre-deployment state. The fasteners 14 are continuous and attached to the access port 10 through holes therein. In operation the fasteners 14 are depressed into the fascia ofthe patient to secure the access port. The NiTi fasteners 14 have the unique ability to change their shape when heated, e.g. to body temperature. As shown in Fig. 21, when the fasteners are deployed they can change shape to bend under the access port 10 and secure it in place. In Fig. 22 the fasteners 14 are shown with straight legs 80 in a deployed state. Alternative configurations include curved legs 81 as shown in Fig. 23. Using the curved legs 81, the fascia can be pinched between the fastener and the underside ofthe access port. A further alternative is shown in Fig. 24 where the tips of the fastener legs 81 are coated with a molded tip 82. The molded tip may be formed in a shape that will assist in piercing the fascia of the patient. This eliminates the need to form the fastener 14 into a shape for piercing. Additionally, the tips 82 may be formed of a bio-absorbable material. In another embodiment of the present invention, the NiTi fastener can be continuously formed in a ring 84. The use of the ring 84 allows for the fasteners 14 to be formed with a continuous construction. After the ring 84 with the fasteners 14 is formed, the ends of the legs 80 can be ground off to produce individual substantially U-shaped fasteners 14. The ring 84 insures that the fasteners 14 can be inserted as a unit as discussed above, and the grinding ofthe legs ensures a sufficiently sharp point to pierce the fascia. As shown in Figs. 25 and 27, the legs can be formed and positioned in the ring 84 so that after bending due to heating, the legs 80 face internally to the access port 10 or externally to the access port 10. Yet another embodiment of the present invention is a two-part fastening system as shown in Figs. 28-34. Fig. 28 shows a guide 90 formed with a plurality of individual fasteners 14. The fasteners 14 are slidable in the guide 90 from a first to a second position. In operation the guide 90 is placed over the access port 10 and aligned with notches 15. The fasteners 14 are formed of a spring like material and shaped to attach to the access port 10. The fasteners 14 are slid from a first position as shown in Fig. 28 to a second position as shown in Fig. 29. The fasteners 14 pierce the fascia and securely hold the access port 14 thereto. As previously described, the fasteners may have straight or curved legs. After the sliding of all of the fasteners from the guide 90 onto the access port 10, the guide may be removed if it is not part ofthe final implanted device. Alternatively, the guide 90 may also be a permanent part ofthe implantable device. A further two-part fastening device includes a pre-formed ring 100 (Fig. 31 and Fig. 32). The ring includes a first securing means 104 for attaching the ring 100 to the fascia. The ring also includes a second securing means 102 for attaching an access port 10 to a secured ring 100. In operation, the ring 100 is placed upon the fascia and then twisted to engage the fascia in the first securing means 104. The access port 10 is then placed upon the ring 100 and engages the second securing means 102 via holes 106 in the access port. This design allows for positive attachment and re-installation repeatability without disengaging the pre-formed ring. Fig. 33 and Fig. 34 depict yet another two-part fastening device comprising an applicator 112 and a ring 110 having NiTi fasteners 114. In practice, the ring 110 is inserted into the applicator 112. The applicator 112 is placed over the access port 10 with the fasteners 114 aligned with notches 115 and holes 106. The fasteners 114 are forced through the holes 106 and engage the fascia of the patient upon which the access port 10 rests. Through the heating process, the fasteners 114 change shape and secure the access port to the fascia. After a predetermined time, the applicator can be removed. Another embodiment of the present invention regards stand alone fasteners. As shown in Figs. 35-38, a variety of designs can be used to secure an access port 10 to the fascia of a patient. The fasteners may incorporate NiTi so that the fasteners change shape upon application of a predetermined amount of heat. These fasteners 14 may be inserted singularly, or as part of a pre-formed ring as discussed above. When inserted singularly, the fasteners 14 may be straight rods or may have some pre-formed shape which may be heightened through the heating process. In Fig. 35, the fastener 14 takes on a curly, pig-tail shape. In Fig. 36 the fastener takes on a substantially C-shaped appearance. Figs. 37 and 38 use U-shaped fasteners 14, the ends of which bend, linearly when heated to form an omega shape as shown in Fig. 37, or perpendicularly to the shape as shown in Fig. 38. These shapes can be chosen as desired for a specific application. Yet another embodiment ofthe present invention is shown in Fig. 39. In Fig. 39 the fasteners 14 are slidably installed in the access port 10. This may be accomplished by cold molding of the NiTi fastening system into the device, and allows positive attachment and repeatable re-positioning. Through the use of an installation tool 120, the fasteners are forced through holes in the bottom of the access port 10 and engage the fascia. By installing the fasteners as an integral part ofthe access port 10, no ring or housing is needed as discussed above for housing the fasteners. The installation tool 120 could be part of a triggering device as disclosed herein. Fig. 40 shows the fastener 14 in the engaged position. As described above and shown in Figures 1-8, radial pivot fasteners are a simple delivery system, with direct drive. The associated delivery system actuates the pivot for radial entry. The staple may be stainless steel, titanium, Nitinol or Elgiloy™, or other suitable materials including other metals or plastics. The molded pivot/lock-out system may be designed to snap into the existing suture holes on implantable devices. Additionally, the simple staple shape allows for easy manufacturability. Such a system is self-puncturing, i.e. no pre-puncturing of the bodily tissue, e.g. fascia, is necessary. The curved nature of the staple allows the penetration into the bodily tissue as the staple advances to be predictable; and the pivoting nature of the curved staple generates an easy path through the tissue. Removal of the fastening system requires an extraction tool, and the staples will rotate out ofthe original entry path with only small resistance from ingrown surrounding tissue. However, the force required to remove the system is adequate to allow the staples to remain locked in position except during a removal procedure. Continuous wire forms of the fastener system contemplated herein include blunt tips, molded tips, and ground or chopped tips. Blunt tip continuous wire systems, as shown in Figures 20-23 may require pre-puncture for insertion of the blunt tipped wire. The fastener assembly may be manufactured to require the locking feature to retain either the wire form or the overmolded ring. The simple wire form may be made of stainless steel, titanium, Elgiloy™, NiTi or other suitable materials. Removal of the fastener assembly may be done easily due to the blunt ends, which provide minimal tissue damage and trauma. Additionally, the blunt tip reduces the force necessary to remove the assembly. The continuous wire form assembly with molded tips, shown in Figures 20 and 24, does not require pre-puncture ofthe bodily tissue, and these tips allow for easy entry into the bodily tissue. Further, the chopped or ground blunt end continuous wire form assembly, Figures 25-27, also requires no pre-puncture of the bodily tissue, which also allows for easy entry into the tissue. The radial slide fastener assembly, depicted herein with flat fasteners (Figures 28 and 29) and curved fasteners (Figure 30), requires a larger entry site than the other fastener assemblies. The fasteners create a path through the bodily tissue that is simple and secure, with added retention in systems utilizing the curved fasteners. Removal of the systems is accomplished with an associated extraction tool that withdraws each fastener from their center position. Alternatively, the fasteners may be manufactured such that removal may be accomplished by lifting the assembly upwards, at which time the fasteners bend to a straightened position, allowing for easy removal. Fig. 41 depicts a helical coil fastener 201, which may optionally be utilized with a port that features a tubing connector extending from the center ofthe base. The corkscrew- type design is mounted to a separate disc 203 which snaps to the port at tabs 202, or alternatively may be mounted to the port itself, centered on the base plate. The disc or port is manually affixed to the tissue by rotation of the disc or port, which causes the coil to travel on a helical path through the tissue. In one embodiment, the coil can have a sharpened tip. A variation of the helical coil fastener is depicted in Fig. 42. Fig. 42 depicts a flat spiral spring 204 that is deflected downward to begin its path through the tissue. The deflecting implement 205 may be withdrawn following implantation, allowing the spring to compress during healing. Compression of the spring will reduce the profile of the implanted coil fastener and can reduce the likelihood of pain induction. Tabs 202 are used for locking a port or other device into the fastener. Figures 43-47 and Figure 55 depict a horizontal coil implantation system. In the horizontal coil system, a metal coil is used horizontally to stitch the port to the tissue. It is well known that such coils can pierce and hold in tissues from their use as mesh tacks in minimally invasive hernia procedures. In this case, the coil travels parallel to the tissue surface instead of perpendicularly, as in the helical coil fasteners described above. A small deployment tool 206 is envisioned to aid in driving the coil 208 through the tissue and the mating holes 207 in the base coil receptacle 209 (see Figs. 46 and 47). Such holes could be straight holes through a ridge on the bottom ofthe base (see Figs. 44, 45 and 47), or curved holes molded into a flat-surfaced base. A top view of a base is shown in Fig. 43. It is envisioned that the last hole would be blind, and that the end ofthe coil would be shaped in a crossbar that could slide over an incline and lock into place, such as into a slot. A variation would feature a path for the coil that curves around the port or base edge, facilitating tool access to the coil. This can also be accomplished by varying the flexibility of the coil. A tube can be added to the tool as a shroud in order to keep the rotating coil from picking up strings of tissue before it travels through the holes. Figs. 48 to 62 depict various embodiments of a metal suture system. This method of port fixation involves the creation of one or multiple closed metal loops below the port base, by using the base itself as a means to close a loop formed by curved metal members (see, e.g. Figs. 48 and 52). Figure 48 illustrates one closed loop, with a single curved metal member shown in its post-deployment position. Figure 49 is a cutaway top view of one embodiment of the invention showing the curved metal members 211 in their pre- deployment position. Figure 57 depicts both a bottom and side view of one embodiment of the invention showing the curved metal members forming a loop with the bottom of the base. Figure 51 shows curved metal members, with the arrows indicating their deployment rotation. Fastening of a port in the above described manner may be done both with one- piece and two-piece systems, whereby a two-piece system may have a ring 210 that attaches to the port or other device by snap-fitting with tabs 202 as shown in Fig. 50. One embodiment includes a deflection tool to separate the point of the metal member from contact with the base allowing the member tip to begin its path downward through the tissue. This can be a circular disc or the port itself. After the point has traveled some distance, the tool is withdrawn, permitting the curved member to then follow a path intersecting with the base. Likewise, another embodiment includes multiple members curved in two planes, such that rotation ofthe base affects the creating of multiple loops. An alternate method to achieve such a loop is with a curved pin 212 that is inserted through the base after it is in its intended tissue location, as seen in Figs. 53 and 54. Such a pin by nature follows an arc through the tissue and can easily be directed back to the port base. Such a pin can be made to lock in place after full travel by adding a right angle bend 213 to the pin that snaps into a slot 214 on the base, or other such well-known means. A variation on this theme includes an additional straight section on the end ofthe pin, parallel to the curved section. A lever arm 215 is used to drive the curved section through the base and to the completion of its intended travel. In yet another embodiment, a two-piece system may be used wherein the port attaches to a folding baseplate 218 with sharp, curved extensions 217 (see Fig. 56). The folded plate is placed on the tissue with the extensions pointed toward the tissue. When the baseplate is unfolded (flattened) the extensions are driven 90 degrees in a rotary path (see Fig. 56). The port is then snapped to the baseplate, locking the extensions in position. In one embodiment, the points ofthe extensions would overlap those from the other half, semi- shielding the points. Figs. 58-62 illustrate a preferred rotating disc fastener system. After being placed in its desired location, the device to be implanted is secured to the tissue using a plurality of curved pins or hooks 501 (Fig. 62), the tips of which rotate through an arc and are received back in or near the baseplate 510 at the end of their travel. A disc 520 within the baseplate 510 rotates, thereby causing lever arms 525 to push against curved hooks 501, which in turn rotate about their fixed axis in the baseplate through an arc until the rotational travel ofthe disc stops. In the fully deployed position (Figs. 59 and 60), the tips of hooks 501 are preferably received back in baseplate 510 to form a closed loop. Alternatively, the tips may form less than a closed loop. In either case, it is preferable that the rotating disc 520 locks in place at the end of its travel to lock the hooks in place. One-way flexible locking tabs 527 that engage stops 515 or other locking means may be used to lock the hooks in place by preventing backward rotation ofthe disc. A deployment tool or delivery system such as that described above with reference to Figures 5-19 may be used to fasten the device in place. The linear motion ofthe plunger 22 and slide pusher 24 is converted into rotational motion through a transmission using gearing or other well known means. Figures 63-72 illustrate a preferred access port delivery system. Referring to Figure 63, which shows the port delivery system in pre-deployment position, lever 605 is attached to handle 607 at hinge 621. Cable sheath 619 is secured to handle 607 by securing pin 623. Cable sheath 619 encloses cable 617 which is attached to lever 605 at the handle end ofthe device at cable stop 615. Cable sheath 619 allows the linear motion of cable 617. At the deployment end, cable 617 is attached to actuator lever 701, which is snapped into port cover 631. As can be seen from Figures 66 and 70, actuator lever 701 and port cover 631 have curved lips 721 for gripping the baseplate of a disc fastener. Additionally, actuator lever 701 has groove 723 to allow the actuator lever to rotate around the baseplate with minimal contact, the only contact being from curved lip 721. Figure 66 shows edge 713 of the actuator lever, which snaps into a matching groove of port cover 631 and secures the actuator lever but allows its rotational motion. Figure 65 shows a top view of the actuator lever, and shows cable stop 705, where the deployment end of cable 617 is attached. Cable 617 runs through slot 707 and out through notch 709 and along groove 711. When the user ofthe deployment tool pulls lever 605 towards handle 607, cable 617 is pulled through the sheath towards handle 607. As the cable is pulled through the sheath, it pulls the actuator lever at cable stop 705, causing the actuator lever to rotate along the path prescribed by edge 713 and its corresponding groove in port cover 631. Figures 69 and 70 show partially exploded and cutaway detail ofthe various parts ofthe actuator lever, port cover and cable assembly. Thus the linear motion of cable 607 is converted to the rotational motion necessary to deploy the fastening system. Figures 71 and 72 show an embodiment of port cover 631 in greater detail. Attachment position 735 is the location where a cable sheath may attach to the port cover. In addition, both Figures 71 and 72 show device passageway 737. Device passageway 737 allows a port cover to be attached to a port or other device without interfering with any tubing or other instrumentation that may be running from the port or device. In this embodiment the passageway is a square shape, however the passageway may be in a wide variety of shapes to accommodate a variety of devices. Figures 73 - 77 depict a loading fixture for holding a combined port/disc fastener assembly. The port/disc fastener system is snapped into the fixture, which protects the assembly, protects the user from accidental contact with the hooks, sharpened points, etc., used to fasten the assembly to tissue, prevents premature deployment of the assembly, and allows the user to load the port/disc fastener system into the deployment tool without actually touching the assembly. The deployment tool is snapped onto the assembly while it is still in the loading fixture. Similar to the device passageway ofthe port cover, the loading fixture has device passageway 739 to allow any tubing to hang freely from the device to be attached without any interference from the loading fixture. Figure 75 shows how a device may be securely held in place by locking tabs 743 and/or pegs 741. Figure 76 shows a port/disc fastener assembly being held securely by the loading fixture. Figure 77 shows an exploded view ofthe disc fastener/loading fixture assembly without a port device attached. A brief description ofthe combined use of preferred embodiment ofthe disc fastener system shown in Figures 58-62, the preferred embodiment of the deployment tool of Figures 63-68 and the loading fixture of Figures 73-77 is helpful in understanding the invention. The user grasps the port delivery system at handle 607. The port/disc fastener assembly would be held in the loading fixture, as shown in Figure 76. The user maneuvers the port cover 631 over the port/disc fastener assembly, and curved lips 721 ofthe actuator lever and port cover snap-fit with the baseplate 510, such that an audible and tactile click is heard and felt by the user. The user then pulls the deployment tool from the loading fixture with the combined port/disc fastener attached and ready to be deployed. The user then positions the combined port/disc fastener system such that the disc fastener is set in its location for deployment. Once in place, the user pulls the lever, setting the actuator lever in motion. Actuation edge 725 engages with a single lever arm 525, rotating the lever arms until the fasteners are fully deployed. Upon full deployment an audible and tactile click is both heard and felt by the user, as the port is ejected from the port delivery system, and the deployment is complete. Although the invention has been particularly shown and described with reference to certain preferred embodiments, and in particular with reference to an access or injection port, it will be readily appreciated by those of ordinary skill in the art that any number of implantable medical devices may be used with the fastening system ofthe present invention and that various changes and modifications may be made therein without departing from the spirit and scope ofthe invention.

Claims

We claim: 1. A method of securing a device to bodily tissue comprising: providing a device having an associated attaching means, wherein the attaching means comprises a housing, wherein the housing surrounds the perimeter of the device and comprises a plurality of notches or openings, wherein the notches or openings comprise a fastening means pivotally attached to the housing; positioning the device and attaching means on the bodily tissue; covering the device and attaching means with a delivery system; activating the delivery system such that the fastening means are pivotally rotated from a first position to a second position to secure the device in bodily tissue, wherein the pivotal rotation is accommodated by the notches or openings, and wherein the fastening means are locked into the second position by a locking tab; and, removing the delivery system from the secured device and attaching means.
2. The method of claim 1, wherein the housing is integral with the body of the device.
3. The method of claim 1, wherein the housing is detachable and surrounds the outside ofthe device, such that the device is securely contained within the housing after said activating step.
4. The method of claim 1, wherein the fastening means is a staple.
5. The method of claim 4, wherein the staple is shaped substantially in the shape of
6. The method of claim 5, wherein a first leg ofthe staple is pivotally attached to the housing.
7. The method of claim 6, wherein a second leg of the staple punctures the bodily tissue when pivotally rotating.
8. The method of claim 7, wherein the staple maintains its shape when pivotally rotating.
9. - The method of claim 6, wherein the staple is locked into position by a locking tab.
10. The method of claim 9, wherein the bodily tissue is secured between the second leg ofthe staple and the device.
11. The method of claim 1, wherein the plurality of notches or openings are spaced equidistant around the housing.
12. The method of claim 4, wherein the staple is comprised of one or more of: stainless steel, Elgiloy™, cobalt-chromium alloy, or nickel-titanium alloy.
13. The method of claim 1, wherein the delivery system comprises a cover, a plunger, a slide pusher and a slide assembly, wherein the slide assembly comprises beams, wherein the beams are spaced so as to line up with the notches or openings on the housing ofthe attaching means.
14. The method of claim 13, wherein the plunger is activated via a pencil grip system, a palm grip system or a pistol grip system.
15. The method of claim 14, wherein the slide assembly moves towards the housing and device when the plunger is activated.
16. The method of claim 15, wherein the beams push against the fastening means when the plunger is activated, causing the fastening means to pivotally rotate.
17. An attaching means for attaching an associated device to bodily tissue, said attaching means comprising a housing, wherein said housing surrounds the perimeter ofthe device and comprises a plurality of notches or openings, wherein said notches or openings comprise fastening means pivotally attached to said housing, wherein said fastening means may be rotated from a first position to a second position to secure the device in bodily tissue.
18. The attaching means of claim 17 further comprising a locking tab for locking said fastening means after rotation into the second position.
19. The attaching means of claim 17, wherein said housing is integral with the body ofthe device.
20. The attaching means of claim 17, wherein said housing is detachable from and substantially surrounds the perimeter ofthe device.
21. The attaching means of claim 17, wherein said fastening means is a staple.
22. The attaching means of claim 21, wherein said staple is shaped as
23. The attaching means of claim 21, wherein a first leg of said staple is pivotally attached to said attaching means.
24. The attaching means of claim 21, wherein a second leg of said staple punctures the bodily tissue when pivotally rotating.
25. The attaching means of claim 24, wherein said staple maintains its shape when pivotally rotating.
26. The attaching means of claim 21, wherein said staple is locked into the second position by a locking tab.
27. The attaching means of claim 24, wherein the bodily tissue is secured between said second leg of said staple and the device.
28. The attaching means of claim 17, wherein said notches or openings are spaced equidistant around said attaching means.
29. The attaching means of claim 17, wherein said fastening means is comprised of one or more of: stainless steel, Elgiloy™, cobalt-chromium alloy, or nickel-titanium alloy.
30. A delivery system for securing a device and associated attaching means to bodily tissue, said delivery system comprising a cover, a plunger, a slide pusher and a slide assembly, wherein said slide assembly comprises beams spaced so as to line up with notches or openings on a housing ofthe attaching means.
31. The delivery system of claim 30, wherein said plunger is activated via a pencil grip system, a palm grip system or a pistol grip system.
32. The delivery system of claim 30, wherein said slide assembly moves towards the housing and device when said plunger is activated.
33. The delivery system of claim 30, wherein said beams push against a fastening means when said plunger is activated, causing the fastening means to pivotally rotate.
34. An implantable device having an outer surface, wherein said outer surface comprises a plurality of notches or openings, wherein said notches or openings house fastening means pivotally attached to said device.
35. A delivery system for use with the implantable device of claim 34, wherein said delivery system comprises a cover, a plunger, a slide pusher and a slide assembly, wherein said slide assembly further comprises beams spaced so as to line up with said notches or openings on said device.
36. The attaching means of claim 20, wherein said housing further comprises pegs to engage suture holes around the perimeter ofthe device.
37. A delivery system for securing a device and associated attaching means to bodily tissue, said delivery system comprising a cover, a plunger, and a slide pusher, and a transmission, wherein said transmission coverts linear motion of said plunger into rotational motion to deploy the attaching means ofthe device.
38. The attaching means of claim 17 further comprising a rotating disc for rotating said fastening means from said first position to said second position.
EP05705996.6A 2004-01-23 2005-01-21 Implantable device fastening system and methods of use Active EP1670362B2 (en)

Priority Applications (3)

Application Number Priority Date Filing Date Title
EP11194523.4A EP2433672B1 (en) 2004-01-23 2005-01-21 Implantable device fastening system
PL05705996T PL1670362T3 (en) 2004-01-23 2005-01-21 Implantable device fastening system and methods of use
EP10181580.1A EP2260773B2 (en) 2004-01-23 2005-01-21 Implantable device fastening system

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US53867404P 2004-01-23 2004-01-23
PCT/US2005/001958 WO2005072627A1 (en) 2004-01-23 2005-01-21 Implantable device fastening system and methods of use

Related Child Applications (5)

Application Number Title Priority Date Filing Date
EP10181580.1A Division-Into EP2260773B2 (en) 2004-01-23 2005-01-21 Implantable device fastening system
EP10181580.1A Division EP2260773B2 (en) 2004-01-23 2005-01-21 Implantable device fastening system
EP11194523.4A Division-Into EP2433672B1 (en) 2004-01-23 2005-01-21 Implantable device fastening system
EP11194523.4A Division EP2433672B1 (en) 2004-01-23 2005-01-21 Implantable device fastening system
EP10181580.1 Division-Into 2010-09-29

Publications (4)

Publication Number Publication Date
EP1670362A1 true EP1670362A1 (en) 2006-06-21
EP1670362A4 EP1670362A4 (en) 2010-02-10
EP1670362B1 EP1670362B1 (en) 2010-12-01
EP1670362B2 EP1670362B2 (en) 2014-10-22

Family

ID=34826003

Family Applications (3)

Application Number Title Priority Date Filing Date
EP05705996.6A Active EP1670362B2 (en) 2004-01-23 2005-01-21 Implantable device fastening system and methods of use
EP11194523.4A Active EP2433672B1 (en) 2004-01-23 2005-01-21 Implantable device fastening system
EP10181580.1A Active EP2260773B2 (en) 2004-01-23 2005-01-21 Implantable device fastening system

Family Applications After (2)

Application Number Title Priority Date Filing Date
EP11194523.4A Active EP2433672B1 (en) 2004-01-23 2005-01-21 Implantable device fastening system
EP10181580.1A Active EP2260773B2 (en) 2004-01-23 2005-01-21 Implantable device fastening system

Country Status (19)

Country Link
US (8) US7901381B2 (en)
EP (3) EP1670362B2 (en)
JP (2) JP4778448B2 (en)
CN (2) CN101507619A (en)
AT (2) ATE489897T1 (en)
AU (2) AU2005209251B2 (en)
BR (1) BRPI0506144B1 (en)
CA (1) CA2567158C (en)
CR (1) CR8328A (en)
DE (1) DE602005025075D1 (en)
DK (1) DK1670362T3 (en)
ES (3) ES2355034T5 (en)
HK (1) HK1086181A1 (en)
IL (1) IL174344A (en)
MX (1) MXPA06003001A (en)
NZ (2) NZ586427A (en)
PL (1) PL1670362T3 (en)
PT (1) PT1670362E (en)
WO (1) WO2005072627A1 (en)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7651483B2 (en) 2005-06-24 2010-01-26 Ethicon Endo-Surgery, Inc. Injection port
US7918844B2 (en) 2005-06-24 2011-04-05 Ethicon Endo-Surgery, Inc. Applier for implantable medical device

Families Citing this family (513)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8795332B2 (en) 2002-09-30 2014-08-05 Ethicon, Inc. Barbed sutures
US6241747B1 (en) 1993-05-03 2001-06-05 Quill Medical, Inc. Barbed Bodily tissue connector
US5931855A (en) 1997-05-21 1999-08-03 Frank Hoffman Surgical methods using one-way suture
US7056331B2 (en) 2001-06-29 2006-06-06 Quill Medical, Inc. Suture method
US6848152B2 (en) 2001-08-31 2005-02-01 Quill Medical, Inc. Method of forming barbs on a suture and apparatus for performing same
US6773450B2 (en) 2002-08-09 2004-08-10 Quill Medical, Inc. Suture anchor and method
US8100940B2 (en) 2002-09-30 2012-01-24 Quill Medical, Inc. Barb configurations for barbed sutures
US20040088003A1 (en) 2002-09-30 2004-05-06 Leung Jeffrey C. Barbed suture in combination with surgical needle
US7624487B2 (en) 2003-05-13 2009-12-01 Quill Medical, Inc. Apparatus and method for forming barbs on a suture
US20070084897A1 (en) 2003-05-20 2007-04-19 Shelton Frederick E Iv Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism
US9060770B2 (en) 2003-05-20 2015-06-23 Ethicon Endo-Surgery, Inc. Robotically-driven surgical instrument with E-beam driver
US7862546B2 (en) 2003-06-16 2011-01-04 Ethicon Endo-Surgery, Inc. Subcutaneous self attaching injection port with integral moveable retention members
US8715243B2 (en) 2003-06-16 2014-05-06 Ethicon Endo-Surgery, Inc. Injection port applier with downward force actuation
US8029477B2 (en) 2003-12-19 2011-10-04 Ethicon Endo-Surgery, Inc. Applier with safety for implantable medical device
ES2529617T3 (en) * 2003-09-15 2015-02-23 Apollo Endosurgery, Inc. Implantable device fixation system
US8162897B2 (en) 2003-12-19 2012-04-24 Ethicon Endo-Surgery, Inc. Audible and tactile feedback
PL1670362T3 (en) * 2004-01-23 2011-05-31 Apollo Endosurgery Inc Implantable device fastening system and methods of use
ES2638301T3 (en) 2004-05-14 2017-10-19 Ethicon Llc Suture devices
US20050148956A1 (en) * 2004-06-01 2005-07-07 Conlon Sean P. Surgically implantable injection port having an improved fastener
US20050277899A1 (en) * 2004-06-01 2005-12-15 Conlon Sean P Method of implanting a fluid injection port
US7955357B2 (en) 2004-07-02 2011-06-07 Ellipse Technologies, Inc. Expandable rod system to treat scoliosis and method of using the same
US11890012B2 (en) 2004-07-28 2024-02-06 Cilag Gmbh International Staple cartridge comprising cartridge body and attached support
US8215531B2 (en) 2004-07-28 2012-07-10 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having a medical substance dispenser
US7909804B2 (en) 2005-02-07 2011-03-22 C. R. Bard, Inc. Vascular access port with integral attachment mechanism
US8029482B2 (en) 2005-03-04 2011-10-04 C. R. Bard, Inc. Systems and methods for radiographically identifying an access port
US7785302B2 (en) 2005-03-04 2010-08-31 C. R. Bard, Inc. Access port identification systems and methods
US9474888B2 (en) 2005-03-04 2016-10-25 C. R. Bard, Inc. Implantable access port including a sandwiched radiopaque insert
US7947022B2 (en) 2005-03-04 2011-05-24 C. R. Bard, Inc. Access port identification systems and methods
US20060217668A1 (en) * 2005-03-22 2006-09-28 Schulze Dale R Method of implanting a subcutaneous injection port having stabilizing elements
US20060217673A1 (en) * 2005-03-22 2006-09-28 Schulze Dale R Subcutaneous injection port with stabilizing elements
US20110288502A1 (en) * 2010-05-18 2011-11-24 C.R. Bard, Inc. Reinforced septum for an implantable medical device
US10307581B2 (en) 2005-04-27 2019-06-04 C. R. Bard, Inc. Reinforced septum for an implantable medical device
EP1874393B1 (en) 2005-04-27 2017-09-06 C.R.Bard, Inc. Infusion apparatuses
EP2939703B1 (en) 2005-04-27 2017-03-01 C. R. Bard, Inc. Infusion apparatuses and related methods
US9237891B2 (en) 2005-08-31 2016-01-19 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical stapling devices that produce formed staples having different lengths
US10159482B2 (en) 2005-08-31 2018-12-25 Ethicon Llc Fastener cartridge assembly comprising a fixed anvil and different staple heights
US11246590B2 (en) 2005-08-31 2022-02-15 Cilag Gmbh International Staple cartridge including staple drivers having different unfired heights
US7934630B2 (en) 2005-08-31 2011-05-03 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US7669746B2 (en) 2005-08-31 2010-03-02 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US11484312B2 (en) 2005-08-31 2022-11-01 Cilag Gmbh International Staple cartridge comprising a staple driver arrangement
US20070106317A1 (en) 2005-11-09 2007-05-10 Shelton Frederick E Iv Hydraulically and electrically actuated articulation joints for surgical instruments
US11278279B2 (en) 2006-01-31 2022-03-22 Cilag Gmbh International Surgical instrument assembly
US8186555B2 (en) 2006-01-31 2012-05-29 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with mechanical closure system
US8820603B2 (en) 2006-01-31 2014-09-02 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US11224427B2 (en) 2006-01-31 2022-01-18 Cilag Gmbh International Surgical stapling system including a console and retraction assembly
US7753904B2 (en) 2006-01-31 2010-07-13 Ethicon Endo-Surgery, Inc. Endoscopic surgical instrument with a handle that can articulate with respect to the shaft
US20110290856A1 (en) 2006-01-31 2011-12-01 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical instrument with force-feedback capabilities
US20110024477A1 (en) 2009-02-06 2011-02-03 Hall Steven G Driven Surgical Stapler Improvements
US20120292367A1 (en) 2006-01-31 2012-11-22 Ethicon Endo-Surgery, Inc. Robotically-controlled end effector
US11793518B2 (en) 2006-01-31 2023-10-24 Cilag Gmbh International Powered surgical instruments with firing system lockout arrangements
US7845537B2 (en) 2006-01-31 2010-12-07 Ethicon Endo-Surgery, Inc. Surgical instrument having recording capabilities
US8708213B2 (en) 2006-01-31 2014-04-29 Ethicon Endo-Surgery, Inc. Surgical instrument having a feedback system
US8992422B2 (en) 2006-03-23 2015-03-31 Ethicon Endo-Surgery, Inc. Robotically-controlled endoscopic accessory channel
US7780590B2 (en) * 2006-05-31 2010-08-24 Allergan, Inc. Method for locating an implanted fluid access port
US8322455B2 (en) 2006-06-27 2012-12-04 Ethicon Endo-Surgery, Inc. Manually driven surgical cutting and fastening instrument
US10568652B2 (en) 2006-09-29 2020-02-25 Ethicon Llc Surgical staples having attached drivers of different heights and stapling instruments for deploying the same
US7506791B2 (en) 2006-09-29 2009-03-24 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with mechanical mechanism for limiting maximum tissue compression
US8019404B2 (en) 2006-10-06 2011-09-13 The Cleveland Clinic Foundation Apparatus and method for targeting a body tissue
US8694077B2 (en) 2006-10-06 2014-04-08 The Cleveland Clinic Foundation Apparatus and method for targeting a body tissue
US7862502B2 (en) 2006-10-20 2011-01-04 Ellipse Technologies, Inc. Method and apparatus for adjusting a gastrointestinal restriction device
US8246533B2 (en) 2006-10-20 2012-08-21 Ellipse Technologies, Inc. Implant system with resonant-driven actuator
US9642986B2 (en) 2006-11-08 2017-05-09 C. R. Bard, Inc. Resource information key for an insertable medical device
US9265912B2 (en) 2006-11-08 2016-02-23 C. R. Bard, Inc. Indicia informative of characteristics of insertable medical devices
US8652120B2 (en) 2007-01-10 2014-02-18 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and sensor transponders
US11291441B2 (en) 2007-01-10 2022-04-05 Cilag Gmbh International Surgical instrument with wireless communication between control unit and remote sensor
US8684253B2 (en) 2007-01-10 2014-04-01 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor
US20080169332A1 (en) 2007-01-11 2008-07-17 Shelton Frederick E Surgical stapling device with a curved cutting member
US11039836B2 (en) 2007-01-11 2021-06-22 Cilag Gmbh International Staple cartridge for use with a surgical stapling instrument
US20090001130A1 (en) 2007-03-15 2009-01-01 Hess Christopher J Surgical procedure using a cutting and stapling instrument having releasable staple-forming pockets
US8893946B2 (en) 2007-03-28 2014-11-25 Ethicon Endo-Surgery, Inc. Laparoscopic tissue thickness and clamp load measuring devices
US20080255612A1 (en) 2007-04-13 2008-10-16 Angiotech Pharmaceuticals, Inc. Self-retaining systems for surgical procedures
US8220689B2 (en) * 2007-05-02 2012-07-17 Endogene Pty Ltd Device and method for delivering shape-memory staples
US11857181B2 (en) 2007-06-04 2024-01-02 Cilag Gmbh International Robotically-controlled shaft based rotary drive systems for surgical instruments
US8931682B2 (en) 2007-06-04 2015-01-13 Ethicon Endo-Surgery, Inc. Robotically-controlled shaft based rotary drive systems for surgical instruments
US7753245B2 (en) 2007-06-22 2010-07-13 Ethicon Endo-Surgery, Inc. Surgical stapling instruments
US11849941B2 (en) 2007-06-29 2023-12-26 Cilag Gmbh International Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis
ES2488406T3 (en) 2007-09-27 2014-08-27 Ethicon Llc Self-retaining sutures that include tissue retention elements with enhanced strength
US20090112262A1 (en) 2007-10-30 2009-04-30 Scott Pool Skeletal manipulation system
US9579496B2 (en) 2007-11-07 2017-02-28 C. R. Bard, Inc. Radiopaque and septum-based indicators for a multi-lumen implantable port
US8916077B1 (en) 2007-12-19 2014-12-23 Ethicon, Inc. Self-retaining sutures with retainers formed from molten material
CN101902974B (en) 2007-12-19 2013-10-30 伊西康有限责任公司 Self-retaining sutures with heat-contact mediated retainers
US8118834B1 (en) 2007-12-20 2012-02-21 Angiotech Pharmaceuticals, Inc. Composite self-retaining sutures and method
US8615856B1 (en) 2008-01-30 2013-12-31 Ethicon, Inc. Apparatus and method for forming self-retaining sutures
WO2009097556A2 (en) 2008-01-30 2009-08-06 Angiotech Pharmaceuticals, Inc. Appartaus and method for forming self-retaining sutures
US8636736B2 (en) 2008-02-14 2014-01-28 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument
US9179912B2 (en) 2008-02-14 2015-11-10 Ethicon Endo-Surgery, Inc. Robotically-controlled motorized surgical cutting and fastening instrument
US7819298B2 (en) 2008-02-14 2010-10-26 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with control features operable with one hand
US7866527B2 (en) 2008-02-14 2011-01-11 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with interlockable firing system
US8573465B2 (en) 2008-02-14 2013-11-05 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical end effector system with rotary actuated closure systems
US8758391B2 (en) 2008-02-14 2014-06-24 Ethicon Endo-Surgery, Inc. Interchangeable tools for surgical instruments
JP5410110B2 (en) 2008-02-14 2014-02-05 エシコン・エンド−サージェリィ・インコーポレイテッド Surgical cutting / fixing instrument with RF electrode
US11272927B2 (en) 2008-02-15 2022-03-15 Cilag Gmbh International Layer arrangements for surgical staple cartridges
US9770245B2 (en) 2008-02-15 2017-09-26 Ethicon Llc Layer arrangements for surgical staple cartridges
BRPI0907787B8 (en) 2008-02-21 2021-06-22 Angiotech Pharm Inc method for forming a self-retaining suture and apparatus for raising the retainers in a suture to a desired angle
US8216273B1 (en) 2008-02-25 2012-07-10 Ethicon, Inc. Self-retainers with supporting structures on a suture
US8641732B1 (en) 2008-02-26 2014-02-04 Ethicon, Inc. Self-retaining suture with variable dimension filament and method
US11202707B2 (en) 2008-03-25 2021-12-21 Nuvasive Specialized Orthopedics, Inc. Adjustable implant system
ES2709687T3 (en) 2008-04-15 2019-04-17 Ethicon Llc Self-retaining sutures with bi-directional retainers or unidirectional retainers
US9023063B2 (en) 2008-04-17 2015-05-05 Apollo Endosurgery, Inc. Implantable access port device having a safety cap
WO2009129474A1 (en) * 2008-04-17 2009-10-22 Allergan, Inc. Implantable access port device and attachment system
US20100051668A1 (en) 2008-09-03 2010-03-04 Milliman Keith L Surgical instrument with indicator
US8210411B2 (en) 2008-09-23 2012-07-03 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument
US9386983B2 (en) 2008-09-23 2016-07-12 Ethicon Endo-Surgery, Llc Robotically-controlled motorized surgical instrument
US9005230B2 (en) 2008-09-23 2015-04-14 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US11648005B2 (en) 2008-09-23 2023-05-16 Cilag Gmbh International Robotically-controlled motorized surgical instrument with an end effector
US8608045B2 (en) 2008-10-10 2013-12-17 Ethicon Endo-Sugery, Inc. Powered surgical cutting and stapling apparatus with manually retractable firing system
US11241257B2 (en) 2008-10-13 2022-02-08 Nuvasive Specialized Orthopedics, Inc. Spinal distraction system
SG196767A1 (en) 2008-11-03 2014-02-13 Ethicon Llc Length of self-retaining suture and method and device for using the same
US8382756B2 (en) 2008-11-10 2013-02-26 Ellipse Technologies, Inc. External adjustment device for distraction device
US8932271B2 (en) 2008-11-13 2015-01-13 C. R. Bard, Inc. Implantable medical devices including septum-based indicators
US11890443B2 (en) 2008-11-13 2024-02-06 C. R. Bard, Inc. Implantable medical devices including septum-based indicators
US8517239B2 (en) 2009-02-05 2013-08-27 Ethicon Endo-Surgery, Inc. Surgical stapling instrument comprising a magnetic element driver
US8444036B2 (en) 2009-02-06 2013-05-21 Ethicon Endo-Surgery, Inc. Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector
CN102341048A (en) 2009-02-06 2012-02-01 伊西康内外科公司 Driven surgical stapler improvements
US8197490B2 (en) 2009-02-23 2012-06-12 Ellipse Technologies, Inc. Non-invasive adjustable distraction system
US9622792B2 (en) 2009-04-29 2017-04-18 Nuvasive Specialized Orthopedics, Inc. Interspinous process device and method
US8708979B2 (en) * 2009-08-26 2014-04-29 Apollo Endosurgery, Inc. Implantable coupling device
US8715158B2 (en) 2009-08-26 2014-05-06 Apollo Endosurgery, Inc. Implantable bottom exit port
US8506532B2 (en) * 2009-08-26 2013-08-13 Allergan, Inc. System including access port and applicator tool
AU2010289288B2 (en) 2009-09-04 2015-11-26 Nuvasive Specialized Orthopedics, Inc. Bone growth device and method
EP2493527B1 (en) * 2009-10-27 2018-12-19 Medical Components, Inc. Multiple vascular access port assembly
WO2011062750A1 (en) 2009-11-17 2011-05-26 C. R. Bard, Inc. Overmolded access port including anchoring and identification features
US8220688B2 (en) 2009-12-24 2012-07-17 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument with electric actuator directional control assembly
US8851354B2 (en) 2009-12-24 2014-10-07 Ethicon Endo-Surgery, Inc. Surgical cutting instrument that analyzes tissue thickness
WO2011090628A2 (en) 2009-12-29 2011-07-28 Angiotech Pharmaceuticals, Inc. Bidirectional self-retaining sutures with laser-marked and/or non-laser marked indicia and methods
US8882728B2 (en) 2010-02-10 2014-11-11 Apollo Endosurgery, Inc. Implantable injection port
US20110270021A1 (en) 2010-04-30 2011-11-03 Allergan, Inc. Electronically enhanced access port for a fluid filled implant
US8992415B2 (en) 2010-04-30 2015-03-31 Apollo Endosurgery, Inc. Implantable device to protect tubing from puncture
US20110270025A1 (en) 2010-04-30 2011-11-03 Allergan, Inc. Remotely powered remotely adjustable gastric band system
CN104706390B (en) 2010-05-04 2017-05-17 伊西康有限责任公司 Laser cutting system and methods for creating self-retaining sutures
ES2615229T3 (en) 2010-06-11 2017-06-06 Ethicon, Llc Suture dispensing tools for endoscopic and robot-assisted surgery and procedures
US9248043B2 (en) 2010-06-30 2016-02-02 Ellipse Technologies, Inc. External adjustment device for distraction device
US8783543B2 (en) 2010-07-30 2014-07-22 Ethicon Endo-Surgery, Inc. Tissue acquisition arrangements and methods for surgical stapling devices
US8734488B2 (en) 2010-08-09 2014-05-27 Ellipse Technologies, Inc. Maintenance feature in magnetic implant
US20120041258A1 (en) 2010-08-16 2012-02-16 Allergan, Inc. Implantable access port system
US20120065460A1 (en) 2010-09-14 2012-03-15 Greg Nitka Implantable access port system
US9320523B2 (en) 2012-03-28 2016-04-26 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising tissue ingrowth features
US9232941B2 (en) 2010-09-30 2016-01-12 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a reservoir
US9788834B2 (en) 2010-09-30 2017-10-17 Ethicon Llc Layer comprising deployable attachment members
US11812965B2 (en) 2010-09-30 2023-11-14 Cilag Gmbh International Layer of material for a surgical end effector
US9629814B2 (en) 2010-09-30 2017-04-25 Ethicon Endo-Surgery, Llc Tissue thickness compensator configured to redistribute compressive forces
US8777004B2 (en) 2010-09-30 2014-07-15 Ethicon Endo-Surgery, Inc. Compressible staple cartridge comprising alignment members
US11925354B2 (en) 2010-09-30 2024-03-12 Cilag Gmbh International Staple cartridge comprising staples positioned within a compressible portion thereof
US10945731B2 (en) 2010-09-30 2021-03-16 Ethicon Llc Tissue thickness compensator comprising controlled release and expansion
US9241714B2 (en) 2011-04-29 2016-01-26 Ethicon Endo-Surgery, Inc. Tissue thickness compensator and method for making the same
US11298125B2 (en) 2010-09-30 2022-04-12 Cilag Gmbh International Tissue stapler having a thickness compensator
US9364233B2 (en) 2010-09-30 2016-06-14 Ethicon Endo-Surgery, Llc Tissue thickness compensators for circular surgical staplers
US8695866B2 (en) 2010-10-01 2014-04-15 Ethicon Endo-Surgery, Inc. Surgical instrument having a power control circuit
JP2014504894A (en) 2010-11-03 2014-02-27 アンジオテック ファーマシューティカルズ, インコーポレイテッド Indwelling suture material for eluting drug and method related thereto
WO2012064902A2 (en) 2010-11-09 2012-05-18 Angiotech Pharmaceuticals, Inc. Emergency self-retaining sutures and packaging
US8942829B2 (en) 2011-01-20 2015-01-27 Medtronic, Inc. Trans-septal lead anchoring
US8715282B2 (en) 2011-02-14 2014-05-06 Ellipse Technologies, Inc. System and method for altering rotational alignment of bone sections
WO2012129534A2 (en) 2011-03-23 2012-09-27 Angiotech Pharmaceuticals, Inc. Self-retaining variable loop sutures
BR112013027794B1 (en) 2011-04-29 2020-12-15 Ethicon Endo-Surgery, Inc CLAMP CARTRIDGE SET
US8821373B2 (en) 2011-05-10 2014-09-02 Apollo Endosurgery, Inc. Directionless (orientation independent) needle injection port
US9072535B2 (en) 2011-05-27 2015-07-07 Ethicon Endo-Surgery, Inc. Surgical stapling instruments with rotatable staple deployment arrangements
US11207064B2 (en) 2011-05-27 2021-12-28 Cilag Gmbh International Automated end effector component reloading system for use with a robotic system
US20130172931A1 (en) 2011-06-06 2013-07-04 Jeffrey M. Gross Methods and devices for soft palate tissue elevation procedures
US8801597B2 (en) 2011-08-25 2014-08-12 Apollo Endosurgery, Inc. Implantable access port with mesh attachment rivets
US10743794B2 (en) 2011-10-04 2020-08-18 Nuvasive Specialized Orthopedics, Inc. Devices and methods for non-invasive implant length sensing
US9199069B2 (en) 2011-10-20 2015-12-01 Apollo Endosurgery, Inc. Implantable injection port
WO2013066946A1 (en) 2011-11-01 2013-05-10 Ellipse Technologies, Inc. Adjustable magnetic devices and methods of using same
US8858421B2 (en) 2011-11-15 2014-10-14 Apollo Endosurgery, Inc. Interior needle stick guard stems for tubes
US9089395B2 (en) 2011-11-16 2015-07-28 Appolo Endosurgery, Inc. Pre-loaded septum for use with an access port
US9044230B2 (en) 2012-02-13 2015-06-02 Ethicon Endo-Surgery, Inc. Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status
RU2014143258A (en) 2012-03-28 2016-05-20 Этикон Эндо-Серджери, Инк. FABRIC THICKNESS COMPENSATOR CONTAINING MANY LAYERS
CN104334098B (en) 2012-03-28 2017-03-22 伊西康内外科公司 Tissue thickness compensator comprising capsules defining a low pressure environment
MX353040B (en) 2012-03-28 2017-12-18 Ethicon Endo Surgery Inc Retainer assembly including a tissue thickness compensator.
US20130338714A1 (en) 2012-06-15 2013-12-19 Arvin Chang Magnetic implants with improved anatomical compatibility
US9101358B2 (en) 2012-06-15 2015-08-11 Ethicon Endo-Surgery, Inc. Articulatable surgical instrument comprising a firing drive
US9282974B2 (en) 2012-06-28 2016-03-15 Ethicon Endo-Surgery, Llc Empty clip cartridge lockout
US9408606B2 (en) 2012-06-28 2016-08-09 Ethicon Endo-Surgery, Llc Robotically powered surgical device with manually-actuatable reversing system
US9289256B2 (en) 2012-06-28 2016-03-22 Ethicon Endo-Surgery, Llc Surgical end effectors having angled tissue-contacting surfaces
US20140005718A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Multi-functional powered surgical device with external dissection features
BR112014032776B1 (en) 2012-06-28 2021-09-08 Ethicon Endo-Surgery, Inc SURGICAL INSTRUMENT SYSTEM AND SURGICAL KIT FOR USE WITH A SURGICAL INSTRUMENT SYSTEM
JP6290201B2 (en) 2012-06-28 2018-03-07 エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. Lockout for empty clip cartridge
US20140001231A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Firing system lockout arrangements for surgical instruments
US11202631B2 (en) 2012-06-28 2021-12-21 Cilag Gmbh International Stapling assembly comprising a firing lockout
US9700310B2 (en) 2013-08-23 2017-07-11 Ethicon Llc Firing member retraction devices for powered surgical instruments
US9044281B2 (en) 2012-10-18 2015-06-02 Ellipse Technologies, Inc. Intramedullary implants for replacing lost bone
ES2691478T3 (en) 2012-10-22 2018-11-27 The Cleveland Clinic Foundation Apparatus for acting on a body tissue
CA2889769A1 (en) 2012-10-29 2014-05-08 Ellipse Technologies, Inc. Adjustable devices for treating arthritis of the knee
US11420033B2 (en) 2013-01-23 2022-08-23 C. R. Bard, Inc. Low-profile single and dual vascular access device
US11464960B2 (en) 2013-01-23 2022-10-11 C. R. Bard, Inc. Low-profile single and dual vascular access device
EP3342391A1 (en) 2013-01-23 2018-07-04 C.R. Bard Inc. Low-profile access port
JP6345707B2 (en) 2013-03-01 2018-06-20 エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. Surgical instrument with soft stop
JP6382235B2 (en) 2013-03-01 2018-08-29 エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. Articulatable surgical instrument with a conductive path for signal communication
US9179938B2 (en) 2013-03-08 2015-11-10 Ellipse Technologies, Inc. Distraction devices and method of assembling the same
US9629629B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgey, LLC Control systems for surgical instruments
US9687230B2 (en) 2013-03-14 2017-06-27 Ethicon Llc Articulatable surgical instrument comprising a firing drive
BR112015026109B1 (en) 2013-04-16 2022-02-22 Ethicon Endo-Surgery, Inc surgical instrument
US9649110B2 (en) 2013-04-16 2017-05-16 Ethicon Llc Surgical instrument comprising a closing drive and a firing drive operated from the same rotatable output
US10226242B2 (en) 2013-07-31 2019-03-12 Nuvasive Specialized Orthopedics, Inc. Noninvasively adjustable suture anchors
US9801734B1 (en) 2013-08-09 2017-10-31 Nuvasive, Inc. Lordotic expandable interbody implant
US9610041B2 (en) 2013-08-20 2017-04-04 Cardiac Pacemakers, Inc. Fixation mechanism assembly and method for implantable devices
MX369362B (en) 2013-08-23 2019-11-06 Ethicon Endo Surgery Llc Firing member retraction devices for powered surgical instruments.
US10751094B2 (en) 2013-10-10 2020-08-25 Nuvasive Specialized Orthopedics, Inc. Adjustable spinal implant
US9962161B2 (en) 2014-02-12 2018-05-08 Ethicon Llc Deliverable surgical instrument
JP6462004B2 (en) 2014-02-24 2019-01-30 エシコン エルエルシー Fastening system with launcher lockout
US10013049B2 (en) 2014-03-26 2018-07-03 Ethicon Llc Power management through sleep options of segmented circuit and wake up control
US20150272571A1 (en) 2014-03-26 2015-10-01 Ethicon Endo-Surgery, Inc. Surgical instrument utilizing sensor adaptation
US20150272557A1 (en) 2014-03-26 2015-10-01 Ethicon Endo-Surgery, Inc. Modular surgical instrument system
BR112016021943B1 (en) 2014-03-26 2022-06-14 Ethicon Endo-Surgery, Llc SURGICAL INSTRUMENT FOR USE BY AN OPERATOR IN A SURGICAL PROCEDURE
CN106456158B (en) 2014-04-16 2019-02-05 伊西康内外科有限责任公司 Fastener cartridge including non-uniform fastener
BR112016023807B1 (en) 2014-04-16 2022-07-12 Ethicon Endo-Surgery, Llc CARTRIDGE SET OF FASTENERS FOR USE WITH A SURGICAL INSTRUMENT
US20150297223A1 (en) 2014-04-16 2015-10-22 Ethicon Endo-Surgery, Inc. Fastener cartridges including extensions having different configurations
JP6636452B2 (en) 2014-04-16 2020-01-29 エシコン エルエルシーEthicon LLC Fastener cartridge including extension having different configurations
US10327764B2 (en) 2014-09-26 2019-06-25 Ethicon Llc Method for creating a flexible staple line
US10299792B2 (en) 2014-04-16 2019-05-28 Ethicon Llc Fastener cartridge comprising non-uniform fasteners
JP6626458B2 (en) 2014-04-28 2019-12-25 ニューヴェイジヴ スペシャライズド オーソペディクス,インコーポレイテッド System for information magnetic feedback in adjustable implants
BR112017004361B1 (en) 2014-09-05 2023-04-11 Ethicon Llc ELECTRONIC SYSTEM FOR A SURGICAL INSTRUMENT
US10111679B2 (en) 2014-09-05 2018-10-30 Ethicon Llc Circuitry and sensors for powered medical device
US11311294B2 (en) 2014-09-05 2022-04-26 Cilag Gmbh International Powered medical device including measurement of closure state of jaws
US10105142B2 (en) 2014-09-18 2018-10-23 Ethicon Llc Surgical stapler with plurality of cutting elements
MX2017003960A (en) 2014-09-26 2017-12-04 Ethicon Llc Surgical stapling buttresses and adjunct materials.
US11523821B2 (en) 2014-09-26 2022-12-13 Cilag Gmbh International Method for creating a flexible staple line
US10076325B2 (en) 2014-10-13 2018-09-18 Ethicon Llc Surgical stapling apparatus comprising a tissue stop
US9924944B2 (en) 2014-10-16 2018-03-27 Ethicon Llc Staple cartridge comprising an adjunct material
US10314619B2 (en) 2014-10-23 2019-06-11 Nuvasive Specialized Orthopedics, Inc. Remotely adjustable interactive bone reshaping implant
US11141153B2 (en) 2014-10-29 2021-10-12 Cilag Gmbh International Staple cartridges comprising driver arrangements
US10517594B2 (en) 2014-10-29 2019-12-31 Ethicon Llc Cartridge assemblies for surgical staplers
US9844376B2 (en) 2014-11-06 2017-12-19 Ethicon Llc Staple cartridge comprising a releasable adjunct material
US10736636B2 (en) 2014-12-10 2020-08-11 Ethicon Llc Articulatable surgical instrument system
BR112017012996B1 (en) 2014-12-18 2022-11-08 Ethicon Llc SURGICAL INSTRUMENT WITH AN ANvil WHICH IS SELECTIVELY MOVABLE ABOUT AN IMMOVABLE GEOMETRIC AXIS DIFFERENT FROM A STAPLE CARTRIDGE
US10085748B2 (en) 2014-12-18 2018-10-02 Ethicon Llc Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors
US9844374B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member
US9943309B2 (en) 2014-12-18 2018-04-17 Ethicon Llc Surgical instruments with articulatable end effectors and movable firing beam support arrangements
US9844375B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Drive arrangements for articulatable surgical instruments
US10188385B2 (en) 2014-12-18 2019-01-29 Ethicon Llc Surgical instrument system comprising lockable systems
US9987000B2 (en) 2014-12-18 2018-06-05 Ethicon Llc Surgical instrument assembly comprising a flexible articulation system
JP6847341B2 (en) 2014-12-26 2021-03-24 ニューベイシブ スペシャライズド オーソペディックス,インコーポレイテッド Systems and methods for extension
WO2016134326A2 (en) 2015-02-19 2016-08-25 Nuvasive, Inc. Systems and methods for vertebral adjustment
US11154301B2 (en) 2015-02-27 2021-10-26 Cilag Gmbh International Modular stapling assembly
US10180463B2 (en) 2015-02-27 2019-01-15 Ethicon Llc Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band
US20160249910A1 (en) 2015-02-27 2016-09-01 Ethicon Endo-Surgery, Llc Surgical charging system that charges and/or conditions one or more batteries
JP2020121162A (en) 2015-03-06 2020-08-13 エシコン エルエルシーEthicon LLC Time dependent evaluation of sensor data to determine stability element, creep element and viscoelastic element of measurement
US9993248B2 (en) 2015-03-06 2018-06-12 Ethicon Endo-Surgery, Llc Smart sensors with local signal processing
US9808246B2 (en) 2015-03-06 2017-11-07 Ethicon Endo-Surgery, Llc Method of operating a powered surgical instrument
US10617412B2 (en) 2015-03-06 2020-04-14 Ethicon Llc System for detecting the mis-insertion of a staple cartridge into a surgical stapler
US9901342B2 (en) 2015-03-06 2018-02-27 Ethicon Endo-Surgery, Llc Signal and power communication system positioned on a rotatable shaft
US10687806B2 (en) 2015-03-06 2020-06-23 Ethicon Llc Adaptive tissue compression techniques to adjust closure rates for multiple tissue types
US10548504B2 (en) 2015-03-06 2020-02-04 Ethicon Llc Overlaid multi sensor radio frequency (RF) electrode system to measure tissue compression
US10441279B2 (en) 2015-03-06 2019-10-15 Ethicon Llc Multiple level thresholds to modify operation of powered surgical instruments
US9924961B2 (en) 2015-03-06 2018-03-27 Ethicon Endo-Surgery, Llc Interactive feedback system for powered surgical instruments
US10245033B2 (en) 2015-03-06 2019-04-02 Ethicon Llc Surgical instrument comprising a lockable battery housing
US10213201B2 (en) 2015-03-31 2019-02-26 Ethicon Llc Stapling end effector configured to compensate for an uneven gap between a first jaw and a second jaw
US10835249B2 (en) 2015-08-17 2020-11-17 Ethicon Llc Implantable layers for a surgical instrument
US10105139B2 (en) 2015-09-23 2018-10-23 Ethicon Llc Surgical stapler having downstream current-based motor control
US10238386B2 (en) 2015-09-23 2019-03-26 Ethicon Llc Surgical stapler having motor control based on an electrical parameter related to a motor current
US10327769B2 (en) 2015-09-23 2019-06-25 Ethicon Llc Surgical stapler having motor control based on a drive system component
US10363036B2 (en) 2015-09-23 2019-07-30 Ethicon Llc Surgical stapler having force-based motor control
US10299878B2 (en) 2015-09-25 2019-05-28 Ethicon Llc Implantable adjunct systems for determining adjunct skew
US10478188B2 (en) 2015-09-30 2019-11-19 Ethicon Llc Implantable layer comprising a constricted configuration
US11890015B2 (en) 2015-09-30 2024-02-06 Cilag Gmbh International Compressible adjunct with crossing spacer fibers
US10736633B2 (en) 2015-09-30 2020-08-11 Ethicon Llc Compressible adjunct with looping members
US10980539B2 (en) 2015-09-30 2021-04-20 Ethicon Llc Implantable adjunct comprising bonded layers
EP4218609A1 (en) 2015-10-16 2023-08-02 NuVasive Specialized Orthopedics, Inc. Adjustable devices for treating arthritis of the knee
KR20180093988A (en) 2015-12-10 2018-08-22 누베이시브 스페셜라이즈드 오소페딕스, 인크. External adjustment device for distraction device
US10292704B2 (en) 2015-12-30 2019-05-21 Ethicon Llc Mechanisms for compensating for battery pack failure in powered surgical instruments
US10265068B2 (en) 2015-12-30 2019-04-23 Ethicon Llc Surgical instruments with separable motors and motor control circuits
US10368865B2 (en) 2015-12-30 2019-08-06 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
BR112018015504A2 (en) 2016-01-28 2018-12-18 Nuvasive Specialized Orthopedics, Inc. bone transport systems
US10588625B2 (en) 2016-02-09 2020-03-17 Ethicon Llc Articulatable surgical instruments with off-axis firing beam arrangements
JP6911054B2 (en) 2016-02-09 2021-07-28 エシコン エルエルシーEthicon LLC Surgical instruments with asymmetric joint composition
US11213293B2 (en) 2016-02-09 2022-01-04 Cilag Gmbh International Articulatable surgical instruments with single articulation link arrangements
WO2017139548A1 (en) 2016-02-10 2017-08-17 Nuvasive Specialized Orthopedics, Inc. Systems and methods for controlling multiple surgical variables
US11224426B2 (en) 2016-02-12 2022-01-18 Cilag Gmbh International Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10258331B2 (en) 2016-02-12 2019-04-16 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10448948B2 (en) 2016-02-12 2019-10-22 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US11064997B2 (en) 2016-04-01 2021-07-20 Cilag Gmbh International Surgical stapling instrument
US10617413B2 (en) 2016-04-01 2020-04-14 Ethicon Llc Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts
US10426467B2 (en) 2016-04-15 2019-10-01 Ethicon Llc Surgical instrument with detection sensors
US11607239B2 (en) 2016-04-15 2023-03-21 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US10357247B2 (en) 2016-04-15 2019-07-23 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10828028B2 (en) 2016-04-15 2020-11-10 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10335145B2 (en) 2016-04-15 2019-07-02 Ethicon Llc Modular surgical instrument with configurable operating mode
US11179150B2 (en) 2016-04-15 2021-11-23 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US10456137B2 (en) 2016-04-15 2019-10-29 Ethicon Llc Staple formation detection mechanisms
US10405859B2 (en) 2016-04-15 2019-09-10 Ethicon Llc Surgical instrument with adjustable stop/start control during a firing motion
US10492783B2 (en) 2016-04-15 2019-12-03 Ethicon, Llc Surgical instrument with improved stop/start control during a firing motion
US10433840B2 (en) 2016-04-18 2019-10-08 Ethicon Llc Surgical instrument comprising a replaceable cartridge jaw
US20170296173A1 (en) 2016-04-18 2017-10-19 Ethicon Endo-Surgery, Llc Method for operating a surgical instrument
US11317917B2 (en) 2016-04-18 2022-05-03 Cilag Gmbh International Surgical stapling system comprising a lockable firing assembly
DE102016107587A1 (en) * 2016-04-25 2017-10-26 Aesculap Ag Translated aneurysm clip
CN109790506B (en) * 2016-07-28 2022-08-09 拜奥法尔诊断有限责任公司 Independent nucleic acid processing
US10835246B2 (en) 2016-12-21 2020-11-17 Ethicon Llc Staple cartridges and arrangements of staples and staple cavities therein
US11419606B2 (en) 2016-12-21 2022-08-23 Cilag Gmbh International Shaft assembly comprising a clutch configured to adapt the output of a rotary firing member to two different systems
US11134942B2 (en) 2016-12-21 2021-10-05 Cilag Gmbh International Surgical stapling instruments and staple-forming anvils
JP7010956B2 (en) 2016-12-21 2022-01-26 エシコン エルエルシー How to staple tissue
US10675026B2 (en) 2016-12-21 2020-06-09 Ethicon Llc Methods of stapling tissue
US10888322B2 (en) 2016-12-21 2021-01-12 Ethicon Llc Surgical instrument comprising a cutting member
US20180168625A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Surgical stapling instruments with smart staple cartridges
US10524789B2 (en) 2016-12-21 2020-01-07 Ethicon Llc Laterally actuatable articulation lock arrangements for locking an end effector of a surgical instrument in an articulated configuration
US10485543B2 (en) 2016-12-21 2019-11-26 Ethicon Llc Anvil having a knife slot width
US10588631B2 (en) 2016-12-21 2020-03-17 Ethicon Llc Surgical instruments with positive jaw opening features
US10675025B2 (en) 2016-12-21 2020-06-09 Ethicon Llc Shaft assembly comprising separately actuatable and retractable systems
US10588632B2 (en) 2016-12-21 2020-03-17 Ethicon Llc Surgical end effectors and firing members thereof
US20180168598A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Staple forming pocket arrangements comprising zoned forming surface grooves
US10426471B2 (en) 2016-12-21 2019-10-01 Ethicon Llc Surgical instrument with multiple failure response modes
US20180168615A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Method of deforming staples from two different types of staple cartridges with the same surgical stapling instrument
JP6983893B2 (en) 2016-12-21 2021-12-17 エシコン エルエルシーEthicon LLC Lockout configuration for surgical end effectors and replaceable tool assemblies
US10980536B2 (en) 2016-12-21 2021-04-20 Ethicon Llc No-cartridge and spent cartridge lockout arrangements for surgical staplers
JP2020501779A (en) 2016-12-21 2020-01-23 エシコン エルエルシーEthicon LLC Surgical stapling system
US20180168608A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Surgical instrument system comprising an end effector lockout and a firing assembly lockout
USD890784S1 (en) 2017-06-20 2020-07-21 Ethicon Llc Display panel with changeable graphical user interface
US10881396B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Surgical instrument with variable duration trigger arrangement
USD879808S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with graphical user interface
US11090046B2 (en) 2017-06-20 2021-08-17 Cilag Gmbh International Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument
US10779820B2 (en) 2017-06-20 2020-09-22 Ethicon Llc Systems and methods for controlling motor speed according to user input for a surgical instrument
US10980537B2 (en) 2017-06-20 2021-04-20 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations
US10646220B2 (en) 2017-06-20 2020-05-12 Ethicon Llc Systems and methods for controlling displacement member velocity for a surgical instrument
US10368864B2 (en) 2017-06-20 2019-08-06 Ethicon Llc Systems and methods for controlling displaying motor velocity for a surgical instrument
US10881399B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument
US10390841B2 (en) 2017-06-20 2019-08-27 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
US10327767B2 (en) 2017-06-20 2019-06-25 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
US11517325B2 (en) 2017-06-20 2022-12-06 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured displacement distance traveled over a specified time interval
US11071554B2 (en) 2017-06-20 2021-07-27 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements
US10307170B2 (en) 2017-06-20 2019-06-04 Ethicon Llc Method for closed loop control of motor velocity of a surgical stapling and cutting instrument
US11382638B2 (en) 2017-06-20 2022-07-12 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified displacement distance
US10888321B2 (en) 2017-06-20 2021-01-12 Ethicon Llc Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument
US10624633B2 (en) 2017-06-20 2020-04-21 Ethicon Llc Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument
US10813639B2 (en) 2017-06-20 2020-10-27 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions
USD879809S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with changeable graphical user interface
US11653914B2 (en) 2017-06-20 2023-05-23 Cilag Gmbh International Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector
US10993716B2 (en) 2017-06-27 2021-05-04 Ethicon Llc Surgical anvil arrangements
US10772629B2 (en) 2017-06-27 2020-09-15 Ethicon Llc Surgical anvil arrangements
US11266405B2 (en) 2017-06-27 2022-03-08 Cilag Gmbh International Surgical anvil manufacturing methods
US11141154B2 (en) 2017-06-27 2021-10-12 Cilag Gmbh International Surgical end effectors and anvils
US11324503B2 (en) 2017-06-27 2022-05-10 Cilag Gmbh International Surgical firing member arrangements
US10856869B2 (en) 2017-06-27 2020-12-08 Ethicon Llc Surgical anvil arrangements
US11246592B2 (en) 2017-06-28 2022-02-15 Cilag Gmbh International Surgical instrument comprising an articulation system lockable to a frame
US10765427B2 (en) 2017-06-28 2020-09-08 Ethicon Llc Method for articulating a surgical instrument
EP4070740A1 (en) 2017-06-28 2022-10-12 Cilag GmbH International Surgical instrument comprising selectively actuatable rotatable couplers
USD869655S1 (en) 2017-06-28 2019-12-10 Ethicon Llc Surgical fastener cartridge
US10716614B2 (en) 2017-06-28 2020-07-21 Ethicon Llc Surgical shaft assemblies with slip ring assemblies with increased contact pressure
USD851762S1 (en) 2017-06-28 2019-06-18 Ethicon Llc Anvil
USD854151S1 (en) 2017-06-28 2019-07-16 Ethicon Llc Surgical instrument shaft
USD906355S1 (en) 2017-06-28 2020-12-29 Ethicon Llc Display screen or portion thereof with a graphical user interface for a surgical instrument
US11259805B2 (en) 2017-06-28 2022-03-01 Cilag Gmbh International Surgical instrument comprising firing member supports
US10211586B2 (en) 2017-06-28 2019-02-19 Ethicon Llc Surgical shaft assemblies with watertight housings
US11058424B2 (en) 2017-06-28 2021-07-13 Cilag Gmbh International Surgical instrument comprising an offset articulation joint
US20190000461A1 (en) 2017-06-28 2019-01-03 Ethicon Llc Surgical cutting and fastening devices with pivotable anvil with a tissue locating arrangement in close proximity to an anvil pivot axis
US11564686B2 (en) 2017-06-28 2023-01-31 Cilag Gmbh International Surgical shaft assemblies with flexible interfaces
US10903685B2 (en) 2017-06-28 2021-01-26 Ethicon Llc Surgical shaft assemblies with slip ring assemblies forming capacitive channels
US10932772B2 (en) 2017-06-29 2021-03-02 Ethicon Llc Methods for closed loop velocity control for robotic surgical instrument
US11007022B2 (en) 2017-06-29 2021-05-18 Ethicon Llc Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument
US10398434B2 (en) 2017-06-29 2019-09-03 Ethicon Llc Closed loop velocity control of closure member for robotic surgical instrument
US10898183B2 (en) 2017-06-29 2021-01-26 Ethicon Llc Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing
US10258418B2 (en) 2017-06-29 2019-04-16 Ethicon Llc System for controlling articulation forces
US11304695B2 (en) 2017-08-03 2022-04-19 Cilag Gmbh International Surgical system shaft interconnection
US11471155B2 (en) 2017-08-03 2022-10-18 Cilag Gmbh International Surgical system bailout
USD870264S1 (en) 2017-09-06 2019-12-17 C. R. Bard, Inc. Implantable apheresis port
US10743872B2 (en) 2017-09-29 2020-08-18 Ethicon Llc System and methods for controlling a display of a surgical instrument
US10796471B2 (en) 2017-09-29 2020-10-06 Ethicon Llc Systems and methods of displaying a knife position for a surgical instrument
US10765429B2 (en) 2017-09-29 2020-09-08 Ethicon Llc Systems and methods for providing alerts according to the operational state of a surgical instrument
USD907647S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
US11399829B2 (en) 2017-09-29 2022-08-02 Cilag Gmbh International Systems and methods of initiating a power shutdown mode for a surgical instrument
USD907648S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
US10729501B2 (en) 2017-09-29 2020-08-04 Ethicon Llc Systems and methods for language selection of a surgical instrument
USD917500S1 (en) 2017-09-29 2021-04-27 Ethicon Llc Display screen or portion thereof with graphical user interface
US11134944B2 (en) 2017-10-30 2021-10-05 Cilag Gmbh International Surgical stapler knife motion controls
US11090075B2 (en) 2017-10-30 2021-08-17 Cilag Gmbh International Articulation features for surgical end effector
US10842490B2 (en) 2017-10-31 2020-11-24 Ethicon Llc Cartridge body design with force reduction based on firing completion
US10779903B2 (en) 2017-10-31 2020-09-22 Ethicon Llc Positive shaft rotation lock activated by jaw closure
DE102017127290A1 (en) 2017-11-20 2019-05-23 Aesculap Ag SURGICAL CLIP WITH BELLOW GUIDANCE SYSTEM
US11006955B2 (en) 2017-12-15 2021-05-18 Ethicon Llc End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments
US10779826B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Methods of operating surgical end effectors
US10743875B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member
US10687813B2 (en) 2017-12-15 2020-06-23 Ethicon Llc Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments
US10966718B2 (en) 2017-12-15 2021-04-06 Ethicon Llc Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments
US10869666B2 (en) 2017-12-15 2020-12-22 Ethicon Llc Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument
US11033267B2 (en) 2017-12-15 2021-06-15 Ethicon Llc Systems and methods of controlling a clamping member firing rate of a surgical instrument
US10743874B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Sealed adapters for use with electromechanical surgical instruments
US10828033B2 (en) 2017-12-15 2020-11-10 Ethicon Llc Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto
US10779825B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments
US11071543B2 (en) 2017-12-15 2021-07-27 Cilag Gmbh International Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges
US11197670B2 (en) 2017-12-15 2021-12-14 Cilag Gmbh International Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed
US10835330B2 (en) 2017-12-19 2020-11-17 Ethicon Llc Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly
US10716565B2 (en) 2017-12-19 2020-07-21 Ethicon Llc Surgical instruments with dual articulation drivers
US11020112B2 (en) 2017-12-19 2021-06-01 Ethicon Llc Surgical tools configured for interchangeable use with different controller interfaces
US11045270B2 (en) 2017-12-19 2021-06-29 Cilag Gmbh International Robotic attachment comprising exterior drive actuator
USD910847S1 (en) 2017-12-19 2021-02-16 Ethicon Llc Surgical instrument assembly
US10729509B2 (en) 2017-12-19 2020-08-04 Ethicon Llc Surgical instrument comprising closure and firing locking mechanism
US11311290B2 (en) 2017-12-21 2022-04-26 Cilag Gmbh International Surgical instrument comprising an end effector dampener
US11129680B2 (en) 2017-12-21 2021-09-28 Cilag Gmbh International Surgical instrument comprising a projector
US10682134B2 (en) 2017-12-21 2020-06-16 Ethicon Llc Continuous use self-propelled stapling instrument
US11076853B2 (en) 2017-12-21 2021-08-03 Cilag Gmbh International Systems and methods of displaying a knife position during transection for a surgical instrument
WO2019177933A1 (en) * 2018-03-12 2019-09-19 Admetsys Corporation Intravascular port based sensing and treatment system
US11045192B2 (en) 2018-08-20 2021-06-29 Cilag Gmbh International Fabricating techniques for surgical stapler anvils
US11083458B2 (en) 2018-08-20 2021-08-10 Cilag Gmbh International Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions
US11039834B2 (en) 2018-08-20 2021-06-22 Cilag Gmbh International Surgical stapler anvils with staple directing protrusions and tissue stability features
US11291440B2 (en) 2018-08-20 2022-04-05 Cilag Gmbh International Method for operating a powered articulatable surgical instrument
US10912559B2 (en) 2018-08-20 2021-02-09 Ethicon Llc Reinforced deformable anvil tip for surgical stapler anvil
US10779821B2 (en) 2018-08-20 2020-09-22 Ethicon Llc Surgical stapler anvils with tissue stop features configured to avoid tissue pinch
US11324501B2 (en) 2018-08-20 2022-05-10 Cilag Gmbh International Surgical stapling devices with improved closure members
US10842492B2 (en) 2018-08-20 2020-11-24 Ethicon Llc Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system
USD914878S1 (en) 2018-08-20 2021-03-30 Ethicon Llc Surgical instrument anvil
US11253256B2 (en) 2018-08-20 2022-02-22 Cilag Gmbh International Articulatable motor powered surgical instruments with dedicated articulation motor arrangements
US11207065B2 (en) 2018-08-20 2021-12-28 Cilag Gmbh International Method for fabricating surgical stapler anvils
US10856870B2 (en) 2018-08-20 2020-12-08 Ethicon Llc Switching arrangements for motor powered articulatable surgical instruments
US11298232B2 (en) 2018-12-19 2022-04-12 Longeviti Neuro Solutions Llc Cranial implant with dural window
AU2020217806A1 (en) 2019-02-07 2021-08-26 Nuvasive Specialized Orthopedics, Inc. Ultrasonic communication in medical devices
US11589901B2 (en) 2019-02-08 2023-02-28 Nuvasive Specialized Orthopedics, Inc. External adjustment device
EP3934733A4 (en) * 2019-03-03 2022-11-16 Portal Access, Inc. Subcutaneously changeable vascular access port
US11696761B2 (en) 2019-03-25 2023-07-11 Cilag Gmbh International Firing drive arrangements for surgical systems
US11147551B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11147553B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11172929B2 (en) 2019-03-25 2021-11-16 Cilag Gmbh International Articulation drive arrangements for surgical systems
US11696851B2 (en) * 2019-04-25 2023-07-11 Alcon Inc. Cannula system with retention feature
US11648009B2 (en) 2019-04-30 2023-05-16 Cilag Gmbh International Rotatable jaw tip for a surgical instrument
US11253254B2 (en) 2019-04-30 2022-02-22 Cilag Gmbh International Shaft rotation actuator on a surgical instrument
US11452528B2 (en) 2019-04-30 2022-09-27 Cilag Gmbh International Articulation actuators for a surgical instrument
US11471157B2 (en) 2019-04-30 2022-10-18 Cilag Gmbh International Articulation control mapping for a surgical instrument
US11903581B2 (en) 2019-04-30 2024-02-20 Cilag Gmbh International Methods for stapling tissue using a surgical instrument
US11426251B2 (en) 2019-04-30 2022-08-30 Cilag Gmbh International Articulation directional lights on a surgical instrument
US11432816B2 (en) 2019-04-30 2022-09-06 Cilag Gmbh International Articulation pin for a surgical instrument
US20200375745A1 (en) * 2019-05-14 2020-12-03 Gliaview Llc Ultra-sound compatible artificial cranial prosthesis with customized platforms
US11224497B2 (en) 2019-06-28 2022-01-18 Cilag Gmbh International Surgical systems with multiple RFID tags
US11259803B2 (en) 2019-06-28 2022-03-01 Cilag Gmbh International Surgical stapling system having an information encryption protocol
US11638587B2 (en) 2019-06-28 2023-05-02 Cilag Gmbh International RFID identification systems for surgical instruments
US11219455B2 (en) 2019-06-28 2022-01-11 Cilag Gmbh International Surgical instrument including a lockout key
US11426167B2 (en) 2019-06-28 2022-08-30 Cilag Gmbh International Mechanisms for proper anvil attachment surgical stapling head assembly
US11497492B2 (en) 2019-06-28 2022-11-15 Cilag Gmbh International Surgical instrument including an articulation lock
US11246678B2 (en) 2019-06-28 2022-02-15 Cilag Gmbh International Surgical stapling system having a frangible RFID tag
US11523822B2 (en) 2019-06-28 2022-12-13 Cilag Gmbh International Battery pack including a circuit interrupter
US11241235B2 (en) 2019-06-28 2022-02-08 Cilag Gmbh International Method of using multiple RFID chips with a surgical assembly
US11051807B2 (en) 2019-06-28 2021-07-06 Cilag Gmbh International Packaging assembly including a particulate trap
US11291451B2 (en) 2019-06-28 2022-04-05 Cilag Gmbh International Surgical instrument with battery compatibility verification functionality
US11553971B2 (en) 2019-06-28 2023-01-17 Cilag Gmbh International Surgical RFID assemblies for display and communication
US11660163B2 (en) 2019-06-28 2023-05-30 Cilag Gmbh International Surgical system with RFID tags for updating motor assembly parameters
US11684434B2 (en) 2019-06-28 2023-06-27 Cilag Gmbh International Surgical RFID assemblies for instrument operational setting control
US11298127B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Interational Surgical stapling system having a lockout mechanism for an incompatible cartridge
US11464601B2 (en) 2019-06-28 2022-10-11 Cilag Gmbh International Surgical instrument comprising an RFID system for tracking a movable component
US11376098B2 (en) 2019-06-28 2022-07-05 Cilag Gmbh International Surgical instrument system comprising an RFID system
US11298132B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Inlernational Staple cartridge including a honeycomb extension
US11478241B2 (en) 2019-06-28 2022-10-25 Cilag Gmbh International Staple cartridge including projections
US11399837B2 (en) 2019-06-28 2022-08-02 Cilag Gmbh International Mechanisms for motor control adjustments of a motorized surgical instrument
US11771419B2 (en) 2019-06-28 2023-10-03 Cilag Gmbh International Packaging for a replaceable component of a surgical stapling system
US11627959B2 (en) 2019-06-28 2023-04-18 Cilag Gmbh International Surgical instruments including manual and powered system lockouts
US11576672B2 (en) 2019-12-19 2023-02-14 Cilag Gmbh International Surgical instrument comprising a closure system including a closure member and an opening member driven by a drive screw
US11911032B2 (en) 2019-12-19 2024-02-27 Cilag Gmbh International Staple cartridge comprising a seating cam
US11464512B2 (en) 2019-12-19 2022-10-11 Cilag Gmbh International Staple cartridge comprising a curved deck surface
US11504122B2 (en) 2019-12-19 2022-11-22 Cilag Gmbh International Surgical instrument comprising a nested firing member
US11701111B2 (en) 2019-12-19 2023-07-18 Cilag Gmbh International Method for operating a surgical stapling instrument
US11529137B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Staple cartridge comprising driver retention members
US11446029B2 (en) 2019-12-19 2022-09-20 Cilag Gmbh International Staple cartridge comprising projections extending from a curved deck surface
US11844520B2 (en) 2019-12-19 2023-12-19 Cilag Gmbh International Staple cartridge comprising driver retention members
US11559304B2 (en) 2019-12-19 2023-01-24 Cilag Gmbh International Surgical instrument comprising a rapid closure mechanism
US11607219B2 (en) 2019-12-19 2023-03-21 Cilag Gmbh International Staple cartridge comprising a detachable tissue cutting knife
US11234698B2 (en) 2019-12-19 2022-02-01 Cilag Gmbh International Stapling system comprising a clamp lockout and a firing lockout
US11529139B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Motor driven surgical instrument
US11291447B2 (en) 2019-12-19 2022-04-05 Cilag Gmbh International Stapling instrument comprising independent jaw closing and staple firing systems
US11304696B2 (en) 2019-12-19 2022-04-19 Cilag Gmbh International Surgical instrument comprising a powered articulation system
USD975850S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD976401S1 (en) 2020-06-02 2023-01-24 Cilag Gmbh International Staple cartridge
USD974560S1 (en) 2020-06-02 2023-01-03 Cilag Gmbh International Staple cartridge
USD966512S1 (en) 2020-06-02 2022-10-11 Cilag Gmbh International Staple cartridge
USD967421S1 (en) 2020-06-02 2022-10-18 Cilag Gmbh International Staple cartridge
USD975851S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD975278S1 (en) 2020-06-02 2023-01-10 Cilag Gmbh International Staple cartridge
US20220008706A1 (en) * 2020-07-08 2022-01-13 Portal Access, Inc. Minimally invasive port implantation
US20220031351A1 (en) 2020-07-28 2022-02-03 Cilag Gmbh International Surgical instruments with differential articulation joint arrangements for accommodating flexible actuators
US11517390B2 (en) 2020-10-29 2022-12-06 Cilag Gmbh International Surgical instrument comprising a limited travel switch
US11844518B2 (en) 2020-10-29 2023-12-19 Cilag Gmbh International Method for operating a surgical instrument
USD1013170S1 (en) 2020-10-29 2024-01-30 Cilag Gmbh International Surgical instrument assembly
US11452526B2 (en) 2020-10-29 2022-09-27 Cilag Gmbh International Surgical instrument comprising a staged voltage regulation start-up system
US11779330B2 (en) 2020-10-29 2023-10-10 Cilag Gmbh International Surgical instrument comprising a jaw alignment system
USD980425S1 (en) 2020-10-29 2023-03-07 Cilag Gmbh International Surgical instrument assembly
US11717289B2 (en) 2020-10-29 2023-08-08 Cilag Gmbh International Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable
US11534259B2 (en) 2020-10-29 2022-12-27 Cilag Gmbh International Surgical instrument comprising an articulation indicator
US11896217B2 (en) 2020-10-29 2024-02-13 Cilag Gmbh International Surgical instrument comprising an articulation lock
US11617577B2 (en) 2020-10-29 2023-04-04 Cilag Gmbh International Surgical instrument comprising a sensor configured to sense whether an articulation drive of the surgical instrument is actuatable
US11737751B2 (en) 2020-12-02 2023-08-29 Cilag Gmbh International Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings
US11627960B2 (en) 2020-12-02 2023-04-18 Cilag Gmbh International Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections
US11890010B2 (en) 2020-12-02 2024-02-06 Cllag GmbH International Dual-sided reinforced reload for surgical instruments
US11678882B2 (en) 2020-12-02 2023-06-20 Cilag Gmbh International Surgical instruments with interactive features to remedy incidental sled movements
US11744581B2 (en) 2020-12-02 2023-09-05 Cilag Gmbh International Powered surgical instruments with multi-phase tissue treatment
US11849943B2 (en) 2020-12-02 2023-12-26 Cilag Gmbh International Surgical instrument with cartridge release mechanisms
US11653915B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Surgical instruments with sled location detection and adjustment features
US11653920B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Powered surgical instruments with communication interfaces through sterile barrier
US20220265327A1 (en) 2021-02-23 2022-08-25 Nuvasive Specialized Orthopedics, Inc. Adjustable implant, system and methods
US11723657B2 (en) 2021-02-26 2023-08-15 Cilag Gmbh International Adjustable communication based on available bandwidth and power capacity
US11701113B2 (en) 2021-02-26 2023-07-18 Cilag Gmbh International Stapling instrument comprising a separate power antenna and a data transfer antenna
US11925349B2 (en) 2021-02-26 2024-03-12 Cilag Gmbh International Adjustment to transfer parameters to improve available power
US11793514B2 (en) 2021-02-26 2023-10-24 Cilag Gmbh International Staple cartridge comprising sensor array which may be embedded in cartridge body
US11751869B2 (en) 2021-02-26 2023-09-12 Cilag Gmbh International Monitoring of multiple sensors over time to detect moving characteristics of tissue
US11730473B2 (en) 2021-02-26 2023-08-22 Cilag Gmbh International Monitoring of manufacturing life-cycle
US11696757B2 (en) 2021-02-26 2023-07-11 Cilag Gmbh International Monitoring of internal systems to detect and track cartridge motion status
US11749877B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Stapling instrument comprising a signal antenna
US11744583B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Distal communication array to tune frequency of RF systems
US11812964B2 (en) 2021-02-26 2023-11-14 Cilag Gmbh International Staple cartridge comprising a power management circuit
US11806011B2 (en) 2021-03-22 2023-11-07 Cilag Gmbh International Stapling instrument comprising tissue compression systems
US11826042B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Surgical instrument comprising a firing drive including a selectable leverage mechanism
US11737749B2 (en) 2021-03-22 2023-08-29 Cilag Gmbh International Surgical stapling instrument comprising a retraction system
US11759202B2 (en) 2021-03-22 2023-09-19 Cilag Gmbh International Staple cartridge comprising an implantable layer
US11826012B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Stapling instrument comprising a pulsed motor-driven firing rack
US11723658B2 (en) 2021-03-22 2023-08-15 Cilag Gmbh International Staple cartridge comprising a firing lockout
US11717291B2 (en) 2021-03-22 2023-08-08 Cilag Gmbh International Staple cartridge comprising staples configured to apply different tissue compression
US11786243B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Firing members having flexible portions for adapting to a load during a surgical firing stroke
US11903582B2 (en) 2021-03-24 2024-02-20 Cilag Gmbh International Leveraging surfaces for cartridge installation
US11793516B2 (en) 2021-03-24 2023-10-24 Cilag Gmbh International Surgical staple cartridge comprising longitudinal support beam
US11896218B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Method of using a powered stapling device
US11857183B2 (en) 2021-03-24 2024-01-02 Cilag Gmbh International Stapling assembly components having metal substrates and plastic bodies
US11744603B2 (en) 2021-03-24 2023-09-05 Cilag Gmbh International Multi-axis pivot joints for surgical instruments and methods for manufacturing same
US11832816B2 (en) 2021-03-24 2023-12-05 Cilag Gmbh International Surgical stapling assembly comprising nonplanar staples and planar staples
US11849945B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Rotary-driven surgical stapling assembly comprising eccentrically driven firing member
US11786239B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Surgical instrument articulation joint arrangements comprising multiple moving linkage features
US11849944B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Drivers for fastener cartridge assemblies having rotary drive screws
US11896219B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Mating features between drivers and underside of a cartridge deck
US11737787B1 (en) 2021-05-27 2023-08-29 Nuvasive, Inc. Bone elongating devices and methods of use
US20220378424A1 (en) 2021-05-28 2022-12-01 Cilag Gmbh International Stapling instrument comprising a firing lockout
USD1002009S1 (en) 2021-08-31 2023-10-17 New Wave Endo-Surgical Corp. Medical device
US11877745B2 (en) 2021-10-18 2024-01-23 Cilag Gmbh International Surgical stapling assembly having longitudinally-repeating staple leg clusters

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5540648A (en) * 1992-08-17 1996-07-30 Yoon; Inbae Medical instrument stabilizer with anchoring system and methods
DE19751791A1 (en) * 1997-11-22 1999-05-27 Arnold Dipl Ing Dr Med Pier Surgical stapling instrument with handle and control

Family Cites Families (130)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1174814A (en) 1915-09-17 1916-03-07 Manville E J Machine Co Automatic threader.
US2737954A (en) * 1954-02-12 1956-03-13 Gloria H Knapp Surgical stitching instrument with rotatable needle support
US3371352A (en) 1965-01-19 1968-03-05 Edwards Lab Inc Heart valve for quick implantation having provision for ingrowth of tissue
SE344275B (en) 1966-02-10 1972-04-10 R Gruenert
US3587115A (en) 1966-05-04 1971-06-28 Donald P Shiley Prosthetic sutureless heart valves and implant tools therefor
US3853237A (en) * 1972-11-16 1974-12-10 Ethyl Dev Corp Vial or container with safety closure
US3840018A (en) 1973-01-31 1974-10-08 M Heifetz Clamp for occluding tubular conduits in the human body
US4118805A (en) 1977-02-28 1978-10-10 Codman & Shurtleff, Inc. Artificial sphincter
AU539132B2 (en) 1979-10-30 1984-09-13 Juan Voltas Baro and Hector Ortiz Hurtado Device to obtain continence
US4413985A (en) 1981-09-02 1983-11-08 The United States Of America As Represented By The Dept. Of Health & Human Services Hydrocephalic antenatal vent for intrauterine treatment (HAVIT)
US4408597A (en) 1982-04-23 1983-10-11 The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration Prosthetic occlusive device for an internal passageway
US4492232A (en) 1982-09-30 1985-01-08 United States Surgical Corporation Surgical clip applying apparatus having fixed jaws
US4592339A (en) 1985-06-12 1986-06-03 Mentor Corporation Gastric banding device
US4696288A (en) 1985-08-14 1987-09-29 Kuzmak Lubomyr I Calibrating apparatus and method of using same for gastric banding surgery
US4692146A (en) 1985-10-24 1987-09-08 Cormed, Inc. Multiple vascular access port
US4708140A (en) 1986-05-08 1987-11-24 Baron Howard C Atraumatic vascular balloon clamp
US4762517A (en) 1986-09-18 1988-08-09 Healthcare Technologies, Inc. Subcutaneously-implanted drug delivery system for intravenous injections, and the like
US4760837A (en) 1987-02-19 1988-08-02 Inamed Development Company Apparatus for verifying the position of needle tip within the injection reservoir of an implantable medical device
US4781680A (en) * 1987-03-02 1988-11-01 Vir Engineering Resealable injection site
CA1303934C (en) 1987-11-03 1992-06-23 David T. Green Fascia clip
US4892518A (en) 1987-12-04 1990-01-09 Biocontrol Technology, Inc. Hemodialysis
US4978338A (en) 1988-04-21 1990-12-18 Therex Corp. Implantable infusion apparatus
US4994073A (en) 1989-02-22 1991-02-19 United States Surgical Corp. Skin fastener
US5006115A (en) 1989-07-25 1991-04-09 Medtronic, Inc. Needle placement sensor
US4932960A (en) 1989-09-01 1990-06-12 United States Surgical Corporation Absorbable surgical fastener
US5263930A (en) 1990-03-01 1993-11-23 William D. Ensminger Implantable access devices
US5092897A (en) * 1990-03-15 1992-03-03 Forte Mark R Implantable acetabular prosthetic hip joint with universal adjustability
SE464558B (en) 1990-03-22 1991-05-13 Hepar Ab IMPLANTABLE DEVICE FOR SUSPENSION OF A CHANNEL IN THE BODY OF A LIVE BEING
US5074868A (en) 1990-08-03 1991-12-24 Inamed Development Company Reversible stoma-adjustable gastric band
US5207644A (en) 1991-03-04 1993-05-04 Strecker Ernst P Device with implantable infusion chamber and a catheter extending therefrom
US5226429A (en) 1991-06-20 1993-07-13 Inamed Development Co. Laparoscopic gastric band and method
US5188609A (en) 1991-07-08 1993-02-23 Bryman Medical Inc. Swivel clip medical tube holder
US5527283A (en) * 1992-02-28 1996-06-18 Swisher, Iii; Kyley Safe medical syringe and method of manufacture
DE4221390C1 (en) 1992-06-30 1993-04-01 Haindl, Hans, Dr.Med., 3015 Wennigsen, De
GR930100244A (en) 1992-06-30 1994-02-28 Ethicon Inc Flexible endoscopic surgical port
US5653718A (en) 1994-05-16 1997-08-05 Yoon; Inbae Cannula anchoring system
US5601224A (en) * 1992-10-09 1997-02-11 Ethicon, Inc. Surgical instrument
US5449368A (en) 1993-02-18 1995-09-12 Kuzmak; Lubomyr I. Laparoscopic adjustable gastric banding device and method for implantation and removal thereof
US5601604A (en) 1993-05-27 1997-02-11 Inamed Development Co. Universal gastric band
US5527321A (en) 1993-07-14 1996-06-18 United States Surgical Corporation Instrument for closing trocar puncture wounds
US5944751A (en) 1993-09-17 1999-08-31 Zertl Medical, Inc. Vibratory heart valve
CA2148486A1 (en) * 1993-09-20 1995-03-30 Michael G. Hluchyj Dynamic rate adjustment for overload control in communication networks
AU1011595A (en) 1994-01-13 1995-07-20 Ethicon Inc. Spiral surgical tack
US5591217A (en) 1995-01-04 1997-01-07 Plexus, Inc. Implantable stimulator with replenishable, high value capacitive power source and method therefor
US5904697A (en) 1995-02-24 1999-05-18 Heartport, Inc. Devices and methods for performing a vascular anastomosis
US5695504A (en) 1995-02-24 1997-12-09 Heartport, Inc. Devices and methods for performing a vascular anastomosis
US5637102A (en) * 1995-05-24 1997-06-10 C. R. Bard, Inc. Dual-type catheter connection system
US5989216A (en) 1995-06-29 1999-11-23 Sims Deltec, Inc. Access portal and method
US5607418A (en) 1995-08-22 1997-03-04 Illinois Institute Of Technology Implantable drug delivery apparatus
US6102922A (en) 1995-09-22 2000-08-15 Kirk Promotions Limited Surgical method and device for reducing the food intake of patient
AU2260397A (en) 1996-01-31 1997-08-22 Trustees Of The University Of Pennsylvania, The Remote control drug delivery device
US6048309A (en) 1996-03-04 2000-04-11 Heartport, Inc. Soft tissue retractor and delivery device therefor
US5944696A (en) 1996-06-03 1999-08-31 Bayless; William Brian Swivel clip medical tube holder
US5718682A (en) 1996-06-28 1998-02-17 United States Surgical Corporation Access port device and method of manufacture
US5833698A (en) * 1996-07-23 1998-11-10 United States Surgical Corporation Anastomosis instrument and method
US5713911A (en) * 1996-10-03 1998-02-03 United States Surgical Corporation Surgical clip
US6111506A (en) * 1996-10-15 2000-08-29 Iris Corporation Berhad Method of making an improved security identification document including contactless communication insert unit
US5938669A (en) 1997-05-07 1999-08-17 Klasamed S.A. Adjustable gastric banding device for contracting a patient's stomach
US5871532A (en) 1997-05-22 1999-02-16 Sulzer Intermedics Inc. Epicardial lead for minimally invasive implantation
US6190352B1 (en) * 1997-10-01 2001-02-20 Boston Scientific Corporation Guidewire compatible port and method for inserting same
NL1007349C2 (en) * 1997-10-24 1999-04-27 Suyker Wilhelmus Joseph Leonardus System for the mechanical production of anastomoses between hollow structures; as well as device and applicator for use therewith.
US6254642B1 (en) 1997-12-09 2001-07-03 Thomas V. Taylor Perorally insertable gastroesophageal anti-reflux valve prosthesis and tool for implantation thereof
US6193734B1 (en) 1998-01-23 2001-02-27 Heartport, Inc. System for performing vascular anastomoses
US6203523B1 (en) 1998-02-02 2001-03-20 Medtronic Inc Implantable drug infusion device having a flow regulator
US5910149A (en) 1998-04-29 1999-06-08 Kuzmak; Lubomyr I. Non-slipping gastric band
US6694366B1 (en) * 1998-04-29 2004-02-17 Symbol Technologies, Inc. Data reconciliation between a computer and a mobile data collection terminal
US6074341A (en) 1998-06-09 2000-06-13 Timm Medical Technologies, Inc. Vessel occlusive apparatus and method
US6106550A (en) 1998-07-10 2000-08-22 Sulzer Carbomedics Inc. Implantable attaching ring
US6067991A (en) 1998-08-13 2000-05-30 Forsell; Peter Mechanical food intake restriction device
US6210347B1 (en) 1998-08-13 2001-04-03 Peter Forsell Remote control food intake restriction device
FR2783153B1 (en) 1998-09-14 2000-12-01 Jerome Dargent GASTRIC CONSTRICTION DEVICE
US6024755A (en) 1998-12-11 2000-02-15 Embol-X, Inc. Suture-free clamp and sealing port and methods of use
IL129032A (en) 1999-03-17 2006-12-31 Moshe Dudai Gastric band
US6766186B1 (en) 1999-06-16 2004-07-20 C. R. Bard, Inc. Post biospy tissue marker and method of use
US6461292B1 (en) 1999-08-12 2002-10-08 Obtech Medical Ag Anal incontinence treatment with wireless energy supply
US6453907B1 (en) 1999-08-12 2002-09-24 Obtech Medical Ag Food intake restriction with energy transfer device
US6454699B1 (en) 2000-02-11 2002-09-24 Obtech Medical Ag Food intake restriction with controlled wireless energy supply
FR2799118B1 (en) 1999-10-01 2002-07-12 Medical Innovation Dev ADJUSTABLE GASTRIC IMPLANT
IL132635A0 (en) 1999-10-28 2001-03-19 Niti Alloys Tech Ltd Shape memory alloy clip and method of use thereof
US20030208212A1 (en) 1999-12-07 2003-11-06 Valerio Cigaina Removable gastric band
FR2804011B1 (en) 2000-01-20 2002-07-19 Rc Medical SINGLE CONTROL GASTROPLASTY RING
US6526335B1 (en) * 2000-01-24 2003-02-25 G. Victor Treyz Automobile personal computer systems
US6450946B1 (en) 2000-02-11 2002-09-17 Obtech Medical Ag Food intake restriction with wireless energy transfer
US6475136B1 (en) 2000-02-14 2002-11-05 Obtech Medical Ag Hydraulic heartburn and reflux treatment
US6478783B1 (en) 2000-05-26 2002-11-12 H. Robert Moorehead Anti-sludge medication ports and related methods
US6419696B1 (en) 2000-07-06 2002-07-16 Paul A. Spence Annuloplasty devices and related heart valve repair methods
FR2813786B1 (en) 2000-09-11 2003-03-14 Medical Innovation Dev METHOD AND DEVICE FOR CONTROLLING THE INFLATION OF AN INFLATABLE PROSTHETIC BODY AND PROSTHESIS USING THE SAME
US6432040B1 (en) 2000-09-14 2002-08-13 Nizam N. Meah Implantable esophageal sphincter apparatus for gastroesophageal reflux disease and method
US6511490B2 (en) 2001-06-22 2003-01-28 Antoine Jean Henri Robert Gastric banding device and method
US6457801B1 (en) 2001-06-27 2002-10-01 Lexmark International, Inc. Method and apparatus for measuring ink dry time
US6629988B2 (en) 2001-08-28 2003-10-07 Ethicon, Inc. Composite staple for completing an anastomosis
PT1420716E (en) 2001-08-29 2012-11-21 Ricardo A P De Carvalho An implantable and sealable system for unidirectional delivery of therapeutic agents to targeted tissues
US20030181890A1 (en) 2002-03-22 2003-09-25 Schulze Dale R. Medical device that removably attaches to a bodily organ
GB2389791B (en) 2002-04-30 2006-12-13 Steven Gill Implantable drug delivery pump
FR2839892B1 (en) * 2002-05-27 2005-03-18 Mb Innovation INJECTION DEVICE FOR SINGLE USE INTENDED FOR PRE-FILLING
US7338433B2 (en) 2002-08-13 2008-03-04 Allergan, Inc. Remotely adjustable gastric banding method
DE60331457D1 (en) 2002-08-28 2010-04-08 Allergan Inc TEMPTING MAGNETIC BANDING DEVICE
US20040068233A1 (en) * 2002-10-04 2004-04-08 Dimatteo Kristian Venous access device with detachable suture wings
US8029477B2 (en) 2003-12-19 2011-10-04 Ethicon Endo-Surgery, Inc. Applier with safety for implantable medical device
US7862546B2 (en) 2003-06-16 2011-01-04 Ethicon Endo-Surgery, Inc. Subcutaneous self attaching injection port with integral moveable retention members
US20050131352A1 (en) 2003-06-16 2005-06-16 Conlon Sean P. Subcutaneous injection port for applied fasteners
US7374557B2 (en) 2003-06-16 2008-05-20 Ethicon Endo-Surgery, Inc. Subcutaneous self attaching injection port with integral fasteners
US8715243B2 (en) * 2003-06-16 2014-05-06 Ethicon Endo-Surgery, Inc. Injection port applier with downward force actuation
ES2529617T3 (en) 2003-09-15 2015-02-23 Apollo Endosurgery, Inc. Implantable device fixation system
US7144400B2 (en) 2003-10-01 2006-12-05 Ethicon Endo-Surgery, Inc. Gastric band introduction device
US20050070937A1 (en) 2003-09-30 2005-03-31 Jambor Kristin L. Segmented gastric band
PL1670362T3 (en) * 2004-01-23 2011-05-31 Apollo Endosurgery Inc Implantable device fastening system and methods of use
US7118027B2 (en) * 2004-02-04 2006-10-10 Lester Sussman Method and system to issue an electronic visa of a foreign visitor at a country's foreign consular premises
US7311716B2 (en) 2004-02-20 2007-12-25 Ethicon Endo-Surgery, Inc. Surgically implantable adjustable band having a flat profile when implanted
MXPA06009971A (en) 2004-02-27 2007-08-08 Satiety Inc Methods and devices for reducing hollow organ volume.
US20050240155A1 (en) 2004-04-27 2005-10-27 Conlon Sean P Surgically implantable injection port having a centered catheter connection tube
US7374565B2 (en) 2004-05-28 2008-05-20 Ethicon Endo-Surgery, Inc. Bi-directional infuser pump with volume braking for hydraulically controlling an adjustable gastric band
US7351240B2 (en) 2004-05-28 2008-04-01 Ethicon Endo—Srugery, Inc. Thermodynamically driven reversible infuser pump for use as a remotely controlled gastric band
US7390294B2 (en) 2004-05-28 2008-06-24 Ethicon Endo-Surgery, Inc. Piezo electrically driven bellows infuser for hydraulically controlling an adjustable gastric band
US7481763B2 (en) 2004-05-28 2009-01-27 Ethicon Endo-Surgery, Inc. Metal bellows position feedback for hydraulic control of an adjustable gastric band
US20050277899A1 (en) * 2004-06-01 2005-12-15 Conlon Sean P Method of implanting a fluid injection port
US20050148956A1 (en) * 2004-06-01 2005-07-07 Conlon Sean P. Surgically implantable injection port having an improved fastener
US7351198B2 (en) 2004-06-02 2008-04-01 Ethicon Endo-Surgery, Inc. Implantable adjustable sphincter system
US7191007B2 (en) 2004-06-24 2007-03-13 Ethicon Endo-Surgery, Inc Spatially decoupled twin secondary coils for optimizing transcutaneous energy transfer (TET) power transfer characteristics
US20060173424A1 (en) * 2005-02-01 2006-08-03 Conlon Sean P Surgically implantable injection port having an absorbable fastener
US7909804B2 (en) 2005-02-07 2011-03-22 C. R. Bard, Inc. Vascular access port with integral attachment mechanism
US20060217673A1 (en) * 2005-03-22 2006-09-28 Schulze Dale R Subcutaneous injection port with stabilizing elements
US7416528B2 (en) 2005-07-15 2008-08-26 Ethicon Endo-Surgery, Inc. Latching device for gastric band
US7367937B2 (en) 2005-07-15 2008-05-06 Ethicon Endo-Surgey, Inc. Gastric band
US7364542B2 (en) 2005-07-15 2008-04-29 Ethicon Endo-Surgery, Inc. Gastric band suture tab extender
US7353747B2 (en) 2005-07-28 2008-04-08 Ethicon Endo-Surgery, Inc. Electroactive polymer-based pump
US20070078391A1 (en) * 2005-09-30 2007-04-05 Angiodynamics Inc. Implantable medical device
ATE487503T1 (en) * 2005-10-18 2010-11-15 Cook Biotech Inc MEDICAL DEVICE WITH FIXATIVE AGENTS
US7708722B2 (en) 2006-01-10 2010-05-04 Stealth Therapeutics, Inc. Stabilized implantable vascular access port
US7756657B2 (en) * 2006-11-14 2010-07-13 Abb Inc. System for storing and presenting sensor and spectrum data for batch processes

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5540648A (en) * 1992-08-17 1996-07-30 Yoon; Inbae Medical instrument stabilizer with anchoring system and methods
DE19751791A1 (en) * 1997-11-22 1999-05-27 Arnold Dipl Ing Dr Med Pier Surgical stapling instrument with handle and control

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See also references of WO2005072627A1 *

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7651483B2 (en) 2005-06-24 2010-01-26 Ethicon Endo-Surgery, Inc. Injection port
US7918844B2 (en) 2005-06-24 2011-04-05 Ethicon Endo-Surgery, Inc. Applier for implantable medical device

Also Published As

Publication number Publication date
AU2005209251B2 (en) 2010-02-04
US20090254052A1 (en) 2009-10-08
US8409203B2 (en) 2013-04-02
US8079989B2 (en) 2011-12-20
BRPI0506144B1 (en) 2016-06-14
EP2433672A2 (en) 2012-03-28
US20110245595A1 (en) 2011-10-06
US8007479B2 (en) 2011-08-30
EP2433672A3 (en) 2012-11-07
US20090259190A1 (en) 2009-10-15
EP1670362B1 (en) 2010-12-01
PT1670362E (en) 2011-01-28
EP2260773A1 (en) 2010-12-15
CN1897880A (en) 2007-01-17
EP1670362B2 (en) 2014-10-22
BRPI0506144A (en) 2006-10-24
HK1086181A1 (en) 2006-09-15
IL174344A0 (en) 2006-08-01
AU2005209251A1 (en) 2005-08-11
ES2488826T3 (en) 2014-08-29
JP2011087942A (en) 2011-05-06
JP4778448B2 (en) 2011-09-21
PL1670362T3 (en) 2011-05-31
US20090259191A1 (en) 2009-10-15
NZ586427A (en) 2010-12-24
US7972315B2 (en) 2011-07-05
EP1670362A4 (en) 2010-02-10
ES2355034T3 (en) 2011-03-22
CA2567158A1 (en) 2005-08-11
DE602005025075D1 (en) 2011-01-13
CA2567158C (en) 2011-08-09
MXPA06003001A (en) 2006-06-23
US20100049214A1 (en) 2010-02-25
WO2005072627A1 (en) 2005-08-11
US7947011B2 (en) 2011-05-24
US20090264827A1 (en) 2009-10-22
EP2260773B2 (en) 2014-08-13
ATE489897T1 (en) 2010-12-15
IL174344A (en) 2011-03-31
AU2010201793B2 (en) 2012-08-30
US20100042052A1 (en) 2010-02-18
CN101507619A (en) 2009-08-19
US8317761B2 (en) 2012-11-27
ES2355034T5 (en) 2015-01-26
JP5097816B2 (en) 2012-12-12
EP2260773B1 (en) 2011-12-21
US20060235445A1 (en) 2006-10-19
DK1670362T3 (en) 2011-02-14
ATE537762T1 (en) 2012-01-15
EP2433672B1 (en) 2014-05-07
US7901381B2 (en) 2011-03-08
ES2375930T3 (en) 2012-03-07
NZ548207A (en) 2010-08-27
JP2007533368A (en) 2007-11-22
CR8328A (en) 2006-08-25
US7811275B2 (en) 2010-10-12
AU2010201793A1 (en) 2010-05-27
ES2375930T5 (en) 2014-10-31

Similar Documents

Publication Publication Date Title
EP2260773B2 (en) Implantable device fastening system
EP2311520B1 (en) Implantable device fastening system

Legal Events

Date Code Title Description
PUAI Public reference made under article 153(3) epc to a published international application that has entered the european phase

Free format text: ORIGINAL CODE: 0009012

17P Request for examination filed

Effective date: 20051223

AK Designated contracting states

Kind code of ref document: A1

Designated state(s): AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HU IE IS IT LI LT LU MC NL PL PT RO SE SI SK TR

REG Reference to a national code

Ref country code: HK

Ref legal event code: DE

Ref document number: 1086181

Country of ref document: HK

R17P Request for examination filed (corrected)

Effective date: 20051222

DAX Request for extension of the european patent (deleted)
RAP1 Party data changed (applicant data changed or rights of an application transferred)

Owner name: ALLERGAN, INC.

A4 Supplementary search report drawn up and despatched

Effective date: 20100112

RIC1 Information provided on ipc code assigned before grant

Ipc: A61B 17/072 20060101ALI20100106BHEP

Ipc: A61B 17/34 20060101ALI20100106BHEP

Ipc: A61B 17/04 20060101AFI20050812BHEP

17Q First examination report despatched

Effective date: 20100503

GRAP Despatch of communication of intention to grant a patent

Free format text: ORIGINAL CODE: EPIDOSNIGR1

RIC1 Information provided on ipc code assigned before grant

Ipc: A61B 17/34 20060101ALI20100630BHEP

Ipc: A61B 17/072 20060101ALI20100630BHEP

Ipc: A61B 17/04 20060101AFI20100630BHEP

GRAS Grant fee paid

Free format text: ORIGINAL CODE: EPIDOSNIGR3

GRAA (expected) grant

Free format text: ORIGINAL CODE: 0009210

AK Designated contracting states

Kind code of ref document: B1

Designated state(s): AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HU IE IS IT LI LT LU MC NL PL PT RO SE SI SK TR

REG Reference to a national code

Ref country code: GB

Ref legal event code: FG4D

REG Reference to a national code

Ref country code: CH

Ref legal event code: EP

REG Reference to a national code

Ref country code: IE

Ref legal event code: FG4D

REF Corresponds to:

Ref document number: 602005025075

Country of ref document: DE

Date of ref document: 20110113

Kind code of ref document: P

REG Reference to a national code

Ref country code: CH

Ref legal event code: NV

Representative=s name: NOVAGRAAF INTERNATIONAL SA

REG Reference to a national code

Ref country code: PT

Ref legal event code: SC4A

Free format text: AVAILABILITY OF NATIONAL TRANSLATION

Effective date: 20110121

REG Reference to a national code

Ref country code: RO

Ref legal event code: EPE

REG Reference to a national code

Ref country code: DK

Ref legal event code: T3

REG Reference to a national code

Ref country code: NL

Ref legal event code: T3

REG Reference to a national code

Ref country code: SE

Ref legal event code: TRGR

REG Reference to a national code

Ref country code: ES

Ref legal event code: FG2A

Effective date: 20110310

REG Reference to a national code

Ref country code: HK

Ref legal event code: GR

Ref document number: 1086181

Country of ref document: HK

REG Reference to a national code

Ref country code: GR

Ref legal event code: EP

Ref document number: 20110400479

Country of ref document: GR

Effective date: 20110317

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: LT

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20101201

LTIE Lt: invalidation of european patent or patent extension

Effective date: 20101201

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: CY

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20101201

Ref country code: SI

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20101201

REG Reference to a national code

Ref country code: PL

Ref legal event code: T3

Ref country code: CH

Ref legal event code: PFA

Owner name: ALLERGAN, INC.

Free format text: ALLERGAN, INC.#2525 DUPONT DRIVE#IRVINE, CA 92612 (US) -TRANSFER TO- ALLERGAN, INC.#2525 DUPONT DRIVE#IRVINE, CA 92612 (US)

REG Reference to a national code

Ref country code: HU

Ref legal event code: AG4A

Ref document number: E010243

Country of ref document: HU

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: IS

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20110401

Ref country code: EE

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20101201

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: SK

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20101201

Ref country code: MC

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20110131

PLBI Opposition filed

Free format text: ORIGINAL CODE: 0009260

26 Opposition filed

Opponent name: JOHNSON & JOHNSON ETHICON ENDO-SURGERY, INC.

Effective date: 20110901

PLAX Notice of opposition and request to file observation + time limit sent

Free format text: ORIGINAL CODE: EPIDOSNOBS2

REG Reference to a national code

Ref country code: DE

Ref legal event code: R026

Ref document number: 602005025075

Country of ref document: DE

Effective date: 20110901

PLBB Reply of patent proprietor to notice(s) of opposition received

Free format text: ORIGINAL CODE: EPIDOSNOBS3

RDAF Communication despatched that patent is revoked

Free format text: ORIGINAL CODE: EPIDOSNREV1

APBM Appeal reference recorded

Free format text: ORIGINAL CODE: EPIDOSNREFNO

APBP Date of receipt of notice of appeal recorded

Free format text: ORIGINAL CODE: EPIDOSNNOA2O

APAH Appeal reference modified

Free format text: ORIGINAL CODE: EPIDOSCREFNO

PLBP Opposition withdrawn

Free format text: ORIGINAL CODE: 0009264

PLAB Opposition data, opponent's data or that of the opponent's representative modified

Free format text: ORIGINAL CODE: 0009299OPPO

APBQ Date of receipt of statement of grounds of appeal recorded

Free format text: ORIGINAL CODE: EPIDOSNNOA3O

PGFP Annual fee paid to national office [announced via postgrant information from national office to epo]

Ref country code: FI

Payment date: 20130129

Year of fee payment: 9

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: LU

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20110121

APBU Appeal procedure closed

Free format text: ORIGINAL CODE: EPIDOSNNOA9O

REG Reference to a national code

Ref country code: DE

Ref legal event code: R082

Ref document number: 602005025075

Country of ref document: DE

Representative=s name: HOFFMANN - EITLE, DE

RAP2 Party data changed (patent owner data changed or rights of a patent transferred)

Owner name: APOLLO ENDOSURGERY, INC.

REG Reference to a national code

Ref country code: GB

Ref legal event code: 732E

Free format text: REGISTERED BETWEEN 20140327 AND 20140402

REG Reference to a national code

Ref country code: DE

Ref legal event code: R081

Ref document number: 602005025075

Country of ref document: DE

Owner name: APOLLO ENDOSURGERY, INC. (N.D.GES.D. STAATES D, US

Free format text: FORMER OWNER: ALLERGAN, INC., IRVINE, US

Effective date: 20140317

Ref country code: DE

Ref legal event code: R082

Ref document number: 602005025075

Country of ref document: DE

Representative=s name: HOFFMANN - EITLE, DE

Effective date: 20140317

Ref country code: DE

Ref legal event code: R081

Ref document number: 602005025075

Country of ref document: DE

Owner name: APOLLO ENDOSURGERY, INC. (N.D.GES.D. STAATES D, US

Free format text: FORMER OWNER: ALLERGAN, INC., IRVINE, CALIF., US

Effective date: 20140317

Ref country code: DE

Ref legal event code: R082

Ref document number: 602005025075

Country of ref document: DE

Representative=s name: HOFFMANN - EITLE PATENT- UND RECHTSANWAELTE PA, DE

Effective date: 20140317

REG Reference to a national code

Ref country code: FR

Ref legal event code: TP

Owner name: APOLLO ENDOSURGERY, INC., US

Effective date: 20140516

REG Reference to a national code

Ref country code: PT

Ref legal event code: PC4A

Owner name: APOLLO ENDOSURGERY, INC., US

Effective date: 20140606

PUAH Patent maintained in amended form

Free format text: ORIGINAL CODE: 0009272

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: PATENT MAINTAINED AS AMENDED

27A Patent maintained in amended form

Effective date: 20141022

AK Designated contracting states

Kind code of ref document: B2

Designated state(s): AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HU IE IS IT LI LT LU MC NL PL PT RO SE SI SK TR

REG Reference to a national code

Ref country code: DE

Ref legal event code: R102

Ref document number: 602005025075

Country of ref document: DE

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: FI

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20140121

REG Reference to a national code

Ref country code: CH

Ref legal event code: AELC

REG Reference to a national code

Ref country code: DE

Ref legal event code: R102

Ref document number: 602005025075

Country of ref document: DE

Effective date: 20141022

REG Reference to a national code

Ref country code: HK

Ref legal event code: AM43

Ref document number: 1086181

Country of ref document: HK

REG Reference to a national code

Ref country code: FR

Ref legal event code: PLFP

Year of fee payment: 11

REG Reference to a national code

Ref country code: ES

Ref legal event code: DC2A

Ref document number: 2355034

Country of ref document: ES

Kind code of ref document: T5

Effective date: 20150126

REG Reference to a national code

Ref country code: NL

Ref legal event code: T3

REG Reference to a national code

Ref country code: SE

Ref legal event code: NAV

REG Reference to a national code

Ref country code: PT

Ref legal event code: MP4A

Effective date: 20150303

REG Reference to a national code

Ref country code: AT

Ref legal event code: MK05

Ref document number: 489897

Country of ref document: AT

Kind code of ref document: T

Effective date: 20101015

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: PT

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20150310

PGFP Annual fee paid to national office [announced via postgrant information from national office to epo]

Ref country code: DK

Payment date: 20150126

Year of fee payment: 11

Ref country code: PT

Payment date: 20150105

Year of fee payment: 11

Ref country code: RO

Payment date: 20150108

Year of fee payment: 11

Ref country code: CZ

Payment date: 20150109

Year of fee payment: 11

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: GR

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20150123

PGFP Annual fee paid to national office [announced via postgrant information from national office to epo]

Ref country code: GR

Payment date: 20150128

Year of fee payment: 11

Ref country code: AT

Payment date: 20150102

Year of fee payment: 11

REG Reference to a national code

Ref country code: CH

Ref legal event code: PUE

Owner name: APOLLO ENDOSURGERY, INC., US

Free format text: FORMER OWNER: ALLERGAN, INC., US

REG Reference to a national code

Ref country code: HU

Ref legal event code: FH1C

Free format text: FORMER REPRESENTATIVE(S): KOVACS IVANNE, DANUBIA SZABADALMI ES JOGI IRODA KFT., HU

Representative=s name: DANUBIA SZABADALMI ES JOGI IRODA KFT., HU

Ref country code: HU

Ref legal event code: GB9C

Owner name: APOLLO ENDOSURGERY, INC., US

Free format text: FORMER OWNER(S): ALLERGAN, INC., US

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: DK

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20141022

REG Reference to a national code

Ref country code: FR

Ref legal event code: PLFP

Year of fee payment: 12

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: RO

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20141022

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: CZ

Free format text: THE PATENT HAS BEEN ANNULLED BY A DECISION OF A NATIONAL AUTHORITY

Effective date: 20101201

REG Reference to a national code

Ref country code: FR

Ref legal event code: PLFP

Year of fee payment: 13

PGFP Annual fee paid to national office [announced via postgrant information from national office to epo]

Ref country code: NL

Payment date: 20170126

Year of fee payment: 13

PGFP Annual fee paid to national office [announced via postgrant information from national office to epo]

Ref country code: CH

Payment date: 20170127

Year of fee payment: 13

PGFP Annual fee paid to national office [announced via postgrant information from national office to epo]

Ref country code: HU

Payment date: 20170106

Year of fee payment: 13

Ref country code: BG

Payment date: 20170127

Year of fee payment: 13

Ref country code: IE

Payment date: 20170127

Year of fee payment: 13

Ref country code: PL

Payment date: 20170104

Year of fee payment: 13

Ref country code: BE

Payment date: 20170127

Year of fee payment: 13

REG Reference to a national code

Ref country code: FR

Ref legal event code: PLFP

Year of fee payment: 14

PGFP Annual fee paid to national office [announced via postgrant information from national office to epo]

Ref country code: TR

Payment date: 20180108

Year of fee payment: 14

Ref country code: SE

Payment date: 20180129

Year of fee payment: 14

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: SE

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20160122

REG Reference to a national code

Ref country code: CH

Ref legal event code: PL

REG Reference to a national code

Ref country code: NL

Ref legal event code: MM

Effective date: 20180201

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: PL

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20150122

Ref country code: HU

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20180122

REG Reference to a national code

Ref country code: IE

Ref legal event code: MM4A

REG Reference to a national code

Ref country code: BE

Ref legal event code: FP

Effective date: 20150109

Ref country code: BE

Ref legal event code: MM

Effective date: 20180131

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: LI

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20180131

Ref country code: NL

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20180201

Ref country code: CH

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20180131

Ref country code: BE

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20180131

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: PL

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20101201

Ref country code: BG

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20180806

Ref country code: IE

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20180121

REG Reference to a national code

Ref country code: DE

Ref legal event code: R119

Ref document number: 602005025075

Country of ref document: DE

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: DE

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20190801

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: TR

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20190121

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: AT

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20150210

PGFP Annual fee paid to national office [announced via postgrant information from national office to epo]

Ref country code: FR

Payment date: 20230124

Year of fee payment: 19

Ref country code: ES

Payment date: 20230201

Year of fee payment: 19

PGFP Annual fee paid to national office [announced via postgrant information from national office to epo]

Ref country code: IT

Payment date: 20230124

Year of fee payment: 19

Ref country code: GB

Payment date: 20230123

Year of fee payment: 19